Discrepancy between use of lean body mass or nitrogen balance to determine protein requirements for adult cats

Minimum methionine requirement in adult cats as determined by indicator amino acid oxidation

There is a lack of empirical data on the dietary Met requirement, in the presence of Cys or cystine, in adult cats. Thus, the aim of this study was to determine the Met requirement, in the presence of excess Cys, in adult cats at maintenance using the indicator amino acid oxidation (IAAO) technique. Six adult neutered male cats were initially selected and started the study. Cats were adapted to the basal diet sufficient in Met (0.24% dry matter, DM) for 14 d prior to being randomly allocated to one of eight dietary levels of Met (0.10%, 0.13%, 0.17%, 0.22%, 0.27%, 0.33%, 0.38%, and 0.43% DM). Different dietary Met concentrations were achieved by supplementing the basal diet with Met solutions. Alanine was additionally included in the solutions to produce isonitrogenous and isoenergetic diets. Cats underwent a 2-d adaptation period to each experimental diet prior to each IAAO study day. On IAAO study days, 13 meals were offered corresponding to 75% of each cat's daily food allowance. The remaining 25% of their daily food intake was offered after each IAAO study. A bolus dose of NaH13CO3 (0.44 mg kg-1) and l-[1-13C]-phenylalanine (13C-Phe; 4.8 mg kg-1) were provided in fifth and sixth meals, respectively, followed by a constant dose of 13C-Phe (1.04 mg kg-1) in the next meals. Breath samples were collected and total production of 13CO2 was measured every 25 min through respiration calorimetry chambers. Steady state of 13CO2 achieved over at least three breath collections was used to calculate oxidation of 13C-Phe (F13CO2). Competing models were applied using the NLMIXED procedure in SAS to determine the effects of dietary Met on 13CO2. Two cats were removed from the study as they did not eat all meals, which is required to achieve isotopic steady. A breakpoint for the mean Met requirement, with excess of Cys, was identified at 0.24% DM (22.63 mg kg-1) with an upper 95% confidence limit of 0.40% DM (37.71 mg·kg-1), on an energy density of 4,164 kcal of metabolizable energy/kg DM calculated using the modified Atwater factors. The estimated Met requirement, in the presence of excess of Cys, is higher than the current recommendations proposed by the National Research Council's Nutrient Requirement of Dogs and Cats, the Association of American Feed Control Officials, and the European Pet Food Industry Federation.

Beyond the Bowl: Understanding Amino Acid Requirements and Digestibility to Improve Protein Quality Metrics for Dog and Cat Foods

The determination of amino acid (AA) requirements for mammals has traditionally been done through nitrogen (N) balance studies, but this technique underestimates AA requirements in adult animals. There has been a shift toward researchers using the indicator amino acid oxidation (IAAO) technique for the determination of AA requirements in humans, and recently in dogs. However, the determination of AA requirements specific to adult dogs and cats at maintenance is lacking and the current requirements outlined by the National Research Council are based on a dearth of data and are likely underreporting the requirements of indispensable AA (IAA) for the population. To ensure the physiological requirements of our cats and dogs are met, we need methods to accurately and precisely measure digestibility. In vivo methods, such as ileal cannulation, are most commonly used, however, due to ethical considerations, we are moving away from animal models and toward in vitro methods. Harmonized static digestion models have the potential to replace in vivo methods but work needs to be done to have these methods more accurately represent the gastrointestinal tract (GIT) of cats and dogs. The Digestible IAA Score (DIAAS) is one metric that can help define protein quality for individual ingredients or mixed diets that uses AA SID estimates and ideally those can be replaced with in vitro AA digestibility estimates. Finally, we need accurate and reliable laboratory AA analyses to measure the AA present in complete diets, especially those used to quantify methionine (Met) and cysteine (Cys), both often limiting AAs in cat and dog diets. Together, this will guide accurate feed formulation for our companion animals to satisfy requirements while avoiding over-supplying protein, which inevitably contributes to excess N excretion, affecting both the environment and feed sustainability.

Characteristics of Nutrition and Metabolism in Dogs and Cats

Domestic dogs and cats have evolved differentially in some aspects of nutrition, metabolism, chemical sensing, and feeding behavior. The dogs have adapted to omnivorous diets containing taurine-abundant meat and starch-rich plant ingredients. By contrast, domestic cats must consume animal-sourced foods for survival, growth, and development. Both dogs and cats synthesize vitamin C and many amino acids (AAs, such as alanine, asparagine, aspartate, glutamate, glutamine, glycine, proline, and serine), but have a limited ability to form de novo arginine and vitamin D3. Compared with dogs, cats have greater endogenous nitrogen losses and higher dietary requirements for AAs (particularly arginine, taurine, and tyrosine), B-complex vitamins (niacin, thiamin, folate, and biotin), and choline; exhibit greater rates of gluconeogenesis; are less sensitive to AA imbalances and antagonism; are more capable of concentrating urine through renal reabsorption of water; and cannot tolerate high levels of dietary starch due to limited pancreatic α-amylase activity. In addition, dogs can form sufficient taurine from cysteine (for most breeds); arachidonic acid from linoleic acid; eicosapentaenoic acid and docosahexaenoic acid from α-linolenic acid; all-trans-retinol from β-carotene; and niacin from tryptophan. These synthetic pathways, however, are either absent or limited in all cats due to (a) no or low activities of key enzymes (including pyrroline-5-carboxylate synthase, cysteine dioxygenase, ∆6-desaturase, β-carotene dioxygenase, and quinolinate phosphoribosyltransferase) and (b) diversion of intermediates to other metabolic pathways. Dogs can thrive on one large meal daily, select high-fat over low-fat diets, and consume sweet substances. By contrast, cats eat more frequently during light and dark periods, select high-protein over low-protein diets, refuse dry food, enjoy a consistent diet, and cannot taste sweetness. This knowledge guides the feeding and care of dogs and cats, as well as the manufacturing of their foods. As abundant sources of essential nutrients, animal-derived foodstuffs play important roles in optimizing the growth, development, and health of the companion animals.

Amino acid nutrition and metabolism in domestic cats and dogs

Domestic cats and dogs are carnivores that have evolved differentially in the nutrition and metabolism of amino acids. This article highlights both proteinogenic and nonproteinogenic amino acids. Dogs inadequately synthesize citrulline (the precursor of arginine) from glutamine, glutamate, and proline in the small intestine. Although most breeds of dogs have potential for adequately converting cysteine into taurine in the liver, a small proportion (1.3%-2.5%) of the Newfoundland dogs fed commercially available balanced diets exhibit a deficiency of taurine possibly due to gene mutations. Certain breeds of dogs (e.g., golden retrievers) are more prone to taurine deficiency possibly due to lower hepatic activities of cysteine dioxygenase and cysteine sulfinate decarboxylase. De novo synthesis of arginine and taurine is very limited in cats. Thus, concentrations of both taurine and arginine in feline milk are the greatest among domestic mammals. Compared with dogs, cats have greater endogenous nitrogen losses and higher dietary requirements for many amino acids (e.g., arginine, taurine, cysteine, and tyrosine), and are less sensitive to amino acid imbalances and antagonisms. Throughout adulthood, cats and dogs may lose 34% and 21% of their lean body mass, respectively. Adequate intakes of high-quality protein (i.e., 32% and 40% animal protein in diets of aging dogs and cats, respectively; dry matter basis) are recommended to alleviate aging-associated reductions in the mass and function of skeletal muscles and bones. Pet-food grade animal-sourced foodstuffs are excellent sources of both proteinogenic amino acids and taurine for cats and dogs, and can help to optimize their growth, development, and health.

Beneficial effects of a prescription home-prepared diet and of zucchini on urine calcium oxalate supersaturation and urinary parameters in adult cats

OBJECTIVES

From the authors' experience, the consumption of a balanced prescription home-prepared diet that includes zucchini (courgette) benefits cats with recurrent urolithiasis, but there is no published evidence to support this. The aim was to study the effects on urinary parameters of (1) a balanced prescription home-prepared diet containing zucchini, and (2) the addition of zucchini to a dry food, compared with two commercial therapeutic diets.

METHODS

Eight healthy cats were included in a Latin-square designed protocol. Five diets were evaluated: two commercial diets, designed for cats with urinary disorders, one high-moisture (U-WET) and one high-sodium dry (U-DRY); one home-prepared diet (HOME); one commercial dry food for adult maintenance (DRY); and DRY given together with 10 g of zucchini per kg body weight (DRY-Zuc). After a 7-day adaptation period, urine was collected and daily food and water intakes were assessed for 12 days. Urinary parameters, and relative supersaturation (RSS) for calcium oxalate (CaOx) and struvite, were determined. Data underwent repeated measures ANOVA analysis.

RESULTS

The digestibility of energy, dry matter, protein and fat was highest with the HOME diet. CaOx RSS was lowest in cats eating the HOME diet, but not significantly different from the U-WET or U-DRY diets. CaOx RSS was lower in cats eating the DRY-Zuc diet than in cats eating the DRY diet. Struvite RSS did not differ significantly among groups.

CONCLUSIONS AND RELEVANCE

This study shows that a balanced prescription home-prepared diet was safe and allowed a very low urinary CaOx RSS. It also showed that adding zucchini to dry food lowered the urine CaOx RSS.

Association between protein intake and lean body mass in a group of Masters Athletes

Recommendations for protein intake are based on total body weight; however, these recommendations do not consider lean body mass (LBM). The purpose of the present study was to identify the average protein intake in g/kg LBM in a group of healthy Masters Athletes (≥26 years of age, exercising ≥2 d/week). Data were obtained from a cross-sectional study. Body weight (kg), height (cm) and LBM via dual-energy X-ray absorptiometry were measured. Dietary intake was measured using a 2005 Block Food Frequency Questionnaire. The average energy intake, the percent energy from protein and the average protein intake in g/kg LBM were calculated. Differences between protein intake and the US Recommended Dietary Allowance (US RDA) (0⋅8 g/kg body weight) were determined. Alpha levels were set a priori to P < 0⋅05. A total of 176 participants (94 women, 82 men; 39 ± 11 years of age; body mass index: 24⋅6 ± 3⋅4 kg/m²) were analysed. The average energy intake, the percent protein energy and the average protein intake were 7996⋅9 ± 110⋅9 kilojoules (kJ)/d (1,910⋅4 ± 26⋅5 kcal), 15⋅5 ± 2⋅6 % and 1⋅43 ± 0⋅53 g/kg LBM, respectively. No differences existed between women and men for protein intake/kg LBM. Both sexes had significantly higher protein intakes than the US RDA (P < 0⋅001). We identified the average protein intake (g/kg LBM) in healthy Masters Athletes that may contribute to evolving perspectives on the determination of protein needs. The present study helps establish the relationship between protein intake and LBM so that we may further increase our accuracy when developing future protein recommendations.

Management of Feline Hyperthyroidism and the Need to Prevent Oxidative Stress: What Can We Learn from Human Research?

Feline hyperthyroidism is a clinical syndrome related to an excessive production of thyroid hormones, and it is considered as a spontaneous animal model for human thyrotoxicosis. Many shared features between the feline and the human disease have been identified so far, including pathogenesis, clinical signs, and treatment options. Although methimazole is considered the first-choice drug in both species, several side effects have been described. Furthermore, methimazole could interfere with the oxidative status, already perturbated by the disease. It has been reported in humans that dietary management, mainly through antioxidant supplementation, could mitigate this oxidative burden. The purpose of the review is to describe current therapeutic options in the course of feline hyperthyroidism and to summarize the state of the art relationship between dietary antioxidants administration and the reduction of methimazole side-effects in humans to support the use of this approach also in cats.

Nutritional Management for Dogs and Cats with Chronic Kidney Disease

The nutritional management of canine and feline chronic kidney disease and protein-losing nephropathy is discussed. Special attention is paid to assessment of body composition (body weight, body condition score, and muscle condition score) and the dysrexia that often occurs with kidney disease. Various nutrients of concern are discussed and specific dietary options are provided.

Senior Pet Nutrition and Management

Senior dogs and cats commonly present to veterinary clinics for wellness examinations and for illness. Nutritional needs change in healthy elder pets compared with the young adult life stage. Veterinary health care teams must provide nutritional assessments and individual recommendations, recognizing there is no defined nutrient profile for seniors. Individual variation prevents a one-size-fits-all approach. Advancing age places pets at risk for developing medical conditions. Early detection can lead to earlier nutritional intervention to support recovery, health, and quality of life. However, comorbidities may present a nutritional conundrum, requiring prioritization of problems and nutritional triage to balance needs.

Understanding the Nutritional Needs of Healthy Cats and Those with Diet-Sensitive Conditions

Diets for cats must provide complete nutrition and meet the needs of the individual patient. There is no single diet that is perfect for all cats, and veterinarians must consider the needs of the cat as well as the preferences of the owners when making dietary recommendations. This article focuses on the interface between animal factors and nutritional needs in cats and is divided into 3 sections. Section 1 addresses the dietary needs of healthy cats, including differences among life stages. Section 2 addresses common myths regarding feline nutrition. Section 3 addresses common nutrient-sensitive conditions in cats, including sarcopenia of aging.

Plasma homocysteine concentration in privately owned healthy adult cats: assessment of biological determinants and establishment of a reference interval

OBJECTIVES

The assessment of homocysteine status in diseased cats has indicated high plasma concentrations in chronic kidney disease and yielded conflicting results with respect to cardiovascular disorders. Previous investigations in small populations of normal cats revealed greater-than-expected variability in plasma homocysteine concentration. The purpose of this study was to determine biological determinants and the reference interval (RI) of plasma homocysteine concentration in the feline species, under strict pre-analytical conditions.

METHODS

In this prospective observational study, privately owned healthy adult cats underwent a complete physical examination, urinalysis and blood testing, in order to rule out any signs of disease. Plasma homocysteine concentration was measured using high-performance liquid chromatography-tandem mass spectrometry.

RESULTS

Of 151 cats recruited, 30 cats were not included owing to abnormal physical examination or fractious behaviour, and 30 cats were excluded based on abnormalities on blood work or urinalysis. Plasma homocysteine concentrations >28 µmol/l were associated with a dietary protein content >9.3 g/100 kcal metabolisable energy. The RI for plasma homocysteine concentration was determined to be 6.2-52.3 µmol/l.

CONCLUSIONS AND RELEVANCE

Normal values for plasma homocysteine concentration in cats have a wide RI, suggesting high inter-individual variability. Whether some healthy cats exhibit impaired homocysteine metabolism remains to be elucidated.

Effect of dietary protein intake on the body composition and metabolic parameters of neutered dogs

Neutering is a common veterinary recommendation and is often associated with obesity development. Thus, the aim of the present study was to evaluate the effects of two different amounts of protein intake by neutered dogs regarding maintenance energy requirement (MER), body composition, and biochemical and hormonal parameters. A total of fourteen healthy adult dogs were fed either a diet containing 59·7 g protein/1000 kcal (4184 kJ) (P60) or a diet with 94·0 g protein/1000 kcal (4184 kJ) (P94) for 26 weeks after neutering to maintain their body weight prior to neutering. A mixed model was fitted to verify diet, time and diet × time interaction effects on biochemical parameters, serum concentrations of insulin, glucagon, leptin and insulin-like growth factor-1 (IGF-1). MER and the body composition data were evaluated within diets (paired t test) and within times (unpaired t test). A time effect was found for fructosamine, TAG, total lipids and IGF-1 serum concentrations. The diet × time interaction was significant for glucagon (P < 0·05). No differences between diets in the MER within each time were found. However, there was a reduction in the MER of dogs fed the P60 diet 26 weeks after neutering (P = 0·042). The fat body mass of dogs fed the P60 diet increased (P < 0·05) after neutering, even without a body-weight change. Some of the biochemical parameters changed over time, but all remained within the normal range. For the period evaluated in the present study, a diet with 94·0 g of protein/1000 kcal (4184 kJ) metabolisable energy seems to be a beneficial nutritional strategy to maintain the MER and the body composition of dogs after neutering.

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Con View

Renal diets typically incorporate protein and phosphorus restriction, supplement with potassium and Omega-3 fatty acids, and address metabolic acidosis. Compared to "maintenance" diets, these modifications appear to benefit cats with chronic kidney disease (CKD). However, there is limited data in cats justifying the specific amounts of the nutrients used in these diets, and there is little evidence supporting protein restriction in cats with CKD. Energy intake, maintenance of body weight, and muscle and body condition need to be addressed, and may take precedence over special diets. Further research is needed to better define optimum diets for cats with CKD.

Evaluation of Body Weight, Body Condition, and Muscle Condition in Cats with Hyperthyroidism

Background

The contribution of fat loss versus muscle wasting to the loss of body weight seen in hyperthyroid cats is unknown.

Objectives

To investigate body weight, body condition score (BCS), and muscle condition score (MCS) in hyperthyroid cats.

Animals

Four hundred sixty‐two cats with untreated hyperthyroidism, 117 of which were reevaluated after treatment.

Methods

Prospective cross‐sectional and before–after studies. Untreated hyperthyroid cats had body composition evaluated (body weight, BCS, and MCS). A subset of these cats were reevaluated 3–12 months after treatment when euthyroid.

Results

Pretreatment body weight (median, 4.36 kg; IQR, 3.5 to 5.2 kg) was lower than premorbid weight (5.45 kg; IQR, 4.6 to 6.4 kg, P < .0001) recorded 1–2 years before diagnosis. 154 (35.3%) cats were thin or emaciated; 357 (77.3%) had loss of muscle mass. Cats showed increases in body weight (median, 4.1 kg to 5.0 kg), BCS (median, 3/5 to 3.5/5), and MCS (2/3 to 3/3) after treatment (P < .001), but mild‐to‐moderate muscle wasting persisted in 45% of treated cats.

Conclusions and Clinical Importance

Most hyperthyroid cats lose body weight but maintain an ideal or overweight BCS, with only a third being underweight. As in human hyperthyroid patients, this weight loss is associated with muscle wasting, which affects >75% of hyperthyroid cats. Successful treatment leads to weight gain and increase of BCS in most cats, but almost half fail to regain normal muscle mass.

The Effect of Moderate Dietary Protein and Phosphate Restriction on Calcium-Phosphate Homeostasis in Healthy Older Cats

Background

Dietary phosphate and protein restriction decreases plasma PTH and FGF‐23 concentrations and improves survival time in azotemic cats, but has not been examined in cats that are not azotemic.

Hypothesis

Feeding a moderately protein‐ and phosphate‐restricted diet decreases PTH and FGF‐23 in healthy older cats and thereby slows progression to azotemic CKD.

Animals

A total of 54 healthy, client‐owned cats (≥ 9 years).

Methods

Prospective double‐blinded randomized placebo‐controlled trial. Cats were assigned to test diet (protein 76 g/Mcal and phosphate 1.6 g/Mcal) or control diet (protein 86 g/Mcal and phosphate 2.6 g/Mcal) and monitored for 18 months. Changes in variables over time and effect of diet were assessed by linear mixed models.

Results

A total of 26 cats ate test diet and 28 cats ate control diet. There was a significant effect of diet on urinary fractional excretion of phosphate (P = 0.045), plasma PTH (P = 0.005), and ionized calcium concentrations (P = 0.018), but not plasma phosphate, FGF‐23, or creatinine concentrations. Plasma PTH concentrations did not significantly change in cats fed the test diet (P = 0.62) but increased over time in cats fed the control diet (P = 0.001). There was no significant treatment effect of the test diet on development of azotemic CKD (3 of 26 (12%) test versus 3 of 28 (11%) control, odds ratio 1.09 (95% CI 0.13–8.94), P = 0.92).

Conclusions and Clinical Importance

Feeding a moderately protein‐ and phosphate‐restricted diet has effects on calcium‐phosphate homeostasis in healthy older cats and is well tolerated. This might have an impact on renal function and could be useful in early chronic kidney disease.

Controversies in Veterinary Nephrology: Differing Viewpoints: Role of Dietary Protein in the Management of Feline Chronic Kidney Disease

The role of diet in management of chronic kidney disease (CKD) is important. There are different interpretations of the current knowledge on this topic. Neither clinical trials involving product testing, nor prospective research investigating dietary influences on cats with induced kidney disease provide guidance on the utility of specific nutritional strategies. Likewise, data derived from other species also has limitations. More research is needed to further our understanding of this topic. However, practical guidance from current knowledge for the management of individual patients can be utilized with success.

Impact of macronutrient composition and palatability in wet diets on food selection in cats

Cats are obligate carnivores adapted to high-protein diets, but are commonly fed diets rich in carbohydrate. The aim of this study was to examine the food intake choices of cats when diets with different protein and carbohydrate contents were offered. Thirty-nine cats participated in voluntary dietary intake studies. Four foods were formulated to provide between 24% and 53% of metabolizable energy as protein, between 43% and 11% as carbohydrate and holding dietary fat constant with a contribution of approximately 36%. Foods were offered either singly to evaluate voluntary food intake or in pairs to compare food intake between pairs of diets. Cats regulated their macronutrient intake to attain an overall diet composition that provided 53% of metabolizable energy as protein, 11% as carbohydrate and 36% as fat. The protein contribution corresponded to approximately 6 g of protein/kg body weight/day. High-protein/low-carbohydrate diets were always eaten preferentially over low-protein/high-carbohydrate foods. When low-protein/high-carbohydrate diets were offered, cats limited their food intake to limit daily carbohydrate intake to less than 3 g of carbohydrate/kg body weight. This carbohydrate ceiling may limit protein and even energy intake when only low-protein/high-carbohydrate diets were offered. The inclusion of palatability enhancer in the diets increased food intake but did not change protein or carbohydrate intake patterns, indicating that macronutrient intake can be regulated regardless of the use of palatability enhancers in cats. We conclude that cats can discriminate between diets based on macronutrient composition and regulate their intake to maintain maximal protein intake but limit carbohydrate intake.

ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease

PRACTICAL RELEVANCE

Chronic kidney disease (CKD) is one of the most commonly diagnosed diseases in older cats. In most cats, CKD is also a progressive disease and can be accompanied by a wide range of clinical and clinicopathological changes. These ISFM Consensus Guidelines have been developed by an independent panel of clinicians and academics to provide practical advice on the diagnosis and management of this complex disease.

CLINICAL CHALLENGES

Although CKD is a common clinical problem in cats, the manifestations of disease vary between individuals. Thus there is a need for careful and repeat evaluation of cats with CKD and adjustment of therapy according to individual needs. In addition to addressing problems arising from CKD and improving quality of life (QoL) for the patient, therapy may also target slowing the underlying progression of disease and hence prolonging life. While maintaining QoL is of paramount importance in our patients, this can be challenging when multiple therapies are indicated. In some cases it is necessary to prioritise therapy, given an understanding of what is likely to most benefit the individual patient.

EVIDENCE BASE

In preparing these Guidelines, the Panel has carefully reviewed the existing published literature, and has also graded the quality of evidence for different interventions to help to provide practical recommendations on the therapeutic options for feline CKD. This is a field of veterinary medicine that has benefited from some excellent published clinical research and further research findings will undoubtedly modify the recommendations contained in these Guidelines in the future.

Macronutrients in feline health

Dietary macronutrients include protein, fat, and carbohydrates. Current nutritional recommendations establish minimums but not maximums for protein and fat but not for carbohydrates; thus, commercial feline maintenance diets have a wide range of macronutrient distribution depending on manufacturer, ingredients, and processing. There is growing interest and discussion, however, in defining the ideal macronutrient composition of feline diets to maximize longevity and health. Current recommendations should be tailored to each patient based on age, body condition, presence of muscle mass atrophy, and the presence of disease.