An evidence-based review of the use of therapeutic foods, owner education, exercise, and drugs for the management of obese and overweight pets

How Successful Are Veterinary Weight Management Plans for Canine Patients Experiencing Poor Welfare Due to Being Overweight and Obese?

Overweight and obesity is one of the most significant health and welfare issues affecting companion animals and are linked to several serious medical conditions, reduced welfare, and shortened lifespan. The number of overweight and obese pets increases every year. Overweight and obesity are associated with multiple chronic diseases. Underlying causes include human-related and animal-related factors. Veterinarians encounter overweight and obese canine patients in daily practice and they play an important role in weight management. This research examines the level of veterinary engagement and the success of veterinary management plans for overweight and obese canines over a five-year period. Electronic medical records (EMRs) were collected for 500 canine patients assessed as either overweight or obese and statistically analyzed for level of veterinary engagement (VE), weight loss success, prescription weight loss diet (RX) use, and comorbidities. The average age at the beginning of the study was 61.5 months. A starting Body Condition Score (BCS) of 6 or 7 was most common (87.2%). Twelve different small and large dog breeds were most highly represented (61.1%). Average weight loss rates were low and more dogs gained rather than lost weight (56.5% vs. 43.5%). While VE is important, this study suggests current VE levels are not adequate to successfully combat overweight and obesity or result in improved animal welfare.

Circulating direct infusion MS and NMR metabolomic profiles of post-gonadectomy kittens with or without additional dietary choline supplementation

Choline is beneficial for energy metabolism and growth in various species. Choline may work similarly in kittens at risk of obesity. Direct infusion MS (Di-MS) and NMR spectroscopy were used to investigate the metabolomic signatures of kittens supplemented with or without additional dietary choline for 12 weeks. Fifteen intact male kittens consumed a base diet (3310 mg choline/kg DM) to their daily metabolisable energy requirement (DER) over an 11-week acclimation. Kittens were gonadectomised and assigned, based on body weight, to the base diet (CONTROL, n 7) or the base diet with 300 mg/kgBW0·75 additional choline as choline chloride (CHOLINE, n 8) and offered three times their individual energy requirement divided into three meals. At weeks −1 and 12, fasted blood was sampled and serum analysed for 130 metabolites via Di-MS and fifty-one metabolites via NMR spectroscopy. Changes in fasted metabolites were assessed using a repeated-measures GLIMMIX procedure with time and group as fixed effects, and time as a repeated measure. Metabolites of one-carbon metabolism and lipids increased, and medium-chain acyl carnitines decreased from week −1 to 12 for CHOLINE (P < 0·05), but not CONTROL (P > 0·05). Increases in amino acid, biogenic amine and organic compound concentrations were observed in both groups (P < 0·05). The results suggest impacts of dietary choline at greater intakes than currently recommended on one-carbon metabolism and fatty acid oxidation, and these may promote healthy growth in post-gonadectomy kittens.

Roles of plant-based ingredients and phytonutrients in canine nutrition and health

Dogs possess the ability to obtain essential nutrients, established by the Association of American Feed Control Officials (AAFCO), from both animal‐ and plant‐based ingredients. There has been a recent increase in the popularity of diets that limit or completely exclude certain plant‐based ingredients. Examples of these diets include ‘ancestral’ or ‘evolutionary’ diets, raw meat‐based diets and grain‐free diets. As compared to animal sources, plant‐derived ingredients (including vegetables, fruits, grains, legumes, nuts and seeds) provide many non‐essential phytonutrients with some data suggesting they confer health benefits. This review aims to assess the strength of current evidence on the relationship between the consumption of plant‐based foods and phytonutrients (such as plant‐derived carotenoids, polyphenols and phytosterols) and biomarkers of health and diseases (such as body weight/condition, gastrointestinal health, immune health, cardiovascular health, visual function and cognitive function) from clinical trials and epidemiological studies. This review highlights the potential nutritional and health benefits of including plant‐based ingredients as a part of balanced canine diets. We also highlight current research gaps in existing studies and provide future research directions to inform the impact of incorporating plant‐based ingredients in commercial or home‐prepared diets.

The effects of fiber source on extrusion processing parameters and kibble characteristics of dry cat foods

Cellulose and beet pulp have been commonly used in the pet food industry to increase the dietary fiber content of cat foods. However, pet food companies seek alternatives to these so-called byproducts. Miscanthus grass is grown for its fiber content and may serve as an alternative to traditional fibrous ingredients. The objectives of this study were to determine the effects of fiber sources on extrusion processing and kibble structure of cat foods. Three replicate batches of a complete and balanced foods for adult cats at maintenance each containing 10% of Miscanthus grass, cellulose, or beet pulp was mixed and kibbles were produced on a single-screw extruder. Feed rate, preconditioner water and steam, extruder screw speed, extruder water and steam addition, and knife speed were adjusted to achieve a wet bulk density of 330 g/L. After extrusion, kibbles were dried at 115.5 ºC to less than 10% moisture. Dried kibbles were coated with chicken fat and flavor enhancer. No effects due to fiber source were reported for extrusion parameters or kibble measurements (P > 0.05) with the exception of compression energy, wherein kibbles produced with cellulose required more energy to compress than those containing beet pulp (6,917 N mm vs. 3,591 N mm, respectively). In conclusion, tested fiber sources had no impact on extrusion parameters and most kibble characteristics. Kibbles containing cellulose required more energy to compress than kibbles containing beet pulp. Miscanthus grass could be used as an alternative to traditional fiber sources used to produce cat foods.

Veterinary Pet Supplements and Nutraceuticals

Veterinary pet supplements and nutraceuticals are widely used by dog, cat and horse owners across the United States, generating millions of dollars in revenue for manufacturers. Despite the widespread use of these veterinary products, oversight and regulation remain limited as compared to human dietary supplement regulations. This review describes the current regulation, quality control, safety and efficacy of pet supplements and nutraceuticals targeted towards the dog, cat and horse.

How effective are interventions designed to help owners to change their behaviour so as to manage the weight of their companion dogs? A systematic review and meta-analysis

OBJECTIVE

The present review sought to evaluate whether - and to what extent - targeting owners' behaviour is an effective way to reduce the problem of overweight and obesity among companion dogs.

METHODS

A systematic search of electronic databases identified 14 studies that evaluated the effect of an intervention targeting owners' behaviour on (i) the owner's behaviour or (ii) the weight, (iii) body fat, or (iv) body condition of the dog. We coded aspects of the study design (e.g., the outcome variable), intervention (e.g., use of theory, specific behaviour change techniques or BCTs, inclusion of nutritional intervention alongside the behavioural intervention), and sample (e.g., age, gender, and weight of the dogs at baseline) that could influence the effect sizes.

RESULTS

The interventions had, on average, a medium sized effect on outcomes (d₊ = 0.59, 95% CI: 0.23 to 0.96, k = 14, N = 384). The effect sizes from the primary studies were relatively homogenous, Q(13) = 12.10, p =  .52 and the nature of the intervention, methodological and sample characteristics did not moderate the effect sizes.

CONCLUSIONS AND CLINICAL RELEVANCE

The findings of the review suggest that targeting owners' behaviour can be an effective way to reduce overweight and obesity among companion dogs. However, this conclusion is based on a limited number of studies and so we hope that the present findings serve as the impetus for further research in this area.

Quality of life and owner attitude to dog overweight and obesity in Thailand and the Netherlands

Background

This study investigated whether the body condition score (BCS) and/or culture influences the quality of life (QoL) of dogs, as evaluated by the owner, and whether the BCS is influenced by feeding and exercise and its owner’s culture. To this end, a questionnaire was administered to 355 selected dog owners (Thai and Dutch). Their dogs had a BCS of 3 (normal weight), 4 (overweight) or 5 (obese) but no other physical problems. Instead of using Likert scales, continuous scales were used. Further, data for the questionnaire items were transformed using an integrated z-score methodology.

Results

The magnitude of factor loadings was similar to that reported in a previous study, indicating that the questionnaire is not culture specific. QoL scores for general sickness were significantly higher (worse) in dogs with a higher BCS. Thus even though the dogs were apparently healthy, the BCS influenced the perceived QoL of the dog. Immobility was seen more often in dogs with a higher (poorer) BCS than in dogs with a lower (better) BCS; however, there was no clear relationship between immobility and total activity. The higher the BCS, the less owners felt in control of feeding and exercise. The BCS was higher in the dogs of owners who did not like to exercise. The Thai dogs showed more separation-related behaviour problems when their owner left home than did the Dutch dogs.

Conclusions

The QoL of overweight and obese dogs is mainly influenced by the dog’s physical status. The owners of dogs with a high BCS have less perceived control over feeding and exercise. Our findings indicate that owner attitudes and beliefs essentially cause obesity as a result of a lack of knowledge and perceived control.

Electronic supplementary material

The online version of this article (10.1186/s12917-018-1531-z) contains supplementary material, which is available to authorized users.

Understanding the context for pet cat and dog feeding and exercising behaviour among pet owners in Ireland: a qualitative study

Background

Pet cat and dog obesity contributes to increased risk of several diseases, including cancer and diabetes mellitus as well as a worsening of orthopaedic problems, and a reduction in survival rate. This study aims to develop a better understanding of cat and dog owners’ self-reported beliefs and factors that influence owner behaviour around feeding and exercising their pet cat or dog, as there is a lack of in-depth understanding in this area. Seven focus group discussions, with 43 pet owners in total, were conducted.

Results

Pet owners often reported a perceived a low level of control over feeding; often undermined by other people feeding of their pet, their pets begging for food, and their pets attitude towards food. Treats were used in the absence of owner control over pet begging and emotional attachment, and to influence pet behaviour. The majority of participants had positive attitudes to pet exercise, which could be related to pet specific requirements, especially differences in cats and dogs. There were some negative experiences of stress associated with dog walking and fears over aggressive confrontations with other dogs.

Conclusion

Feeding one’s pet is influenced by beliefs about pet specific needs, pet food and pet health, pet owners’ perceived control over feeding, and the implications for the pet owner. Pet exercise is influenced by beliefs about pet specific exercise needs, and the implications of exercising one’s pet for the pet owner. Understanding owner behaviours on feeding and exercise allows for a more targeted approach to preventing and treating pet obesity.

Obesity, Exercise and Orthopedic Disease

Osteoarthritis is common among aging canine and feline patients. The incidence and severity of clinical lameness are closely correlated to body condition in overweight and obese patients. Excessive adiposity may result in incongruous and excessive mechanical loading that worsens clinical signs in affected patients. Data suggest a potential link between adipokines, obesity-related inflammation, and a worsening of the underlying pathology. Similarly, abnormal physical stress and generalized systemic inflammation propagated by obesity contribute to neurologic signs associated with intervertebral disc disease. Weight loss and exercise are critical to ameliorating the pain and impaired mobility of affected animals.

Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges

Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative.

Dietary Mannoheptulose Does Not Significantly Alter Daily Energy Expenditure in Adult Labrador Retrievers

Mannoheptulose (MH), a sugar found in avocados that inhibits glycolysis in vitro, has been preliminarily investigated as a novel food ingredient for dogs. This study aimed to determine the effects of dietary MH, delivered as an extract of un-ripened avocado, on energy expenditure (EE) in healthy adult Labrador Retriever dogs (total of 12 dogs, 26.99 ± 0.634 kg, 4.9 ± 0.2 y). The study was a double-blind, cross-over with each dog receiving both dietary treatments, control (CON) and MH (400 mg/kg of diet; 6 mg/kg BW), in random order. Resting and post-prandial (10 h) EE and respiratory quotient (RQ) were determined by indirect calorimetry (d 42). The following day, body composition was assessed using dual X-ray absorptiometry. Continuous activity monitoring was conducted using an Atical® accelerometer (d 43–47). A vastus lateralis muscle biopsy was obtained prior to the morning meal (d 49) and 4 h after consumption of their meal (d 56) to determine the protein content and phosphorylation of 5' adenosine monophosphate-activated protein kinase (AMPK). Diet did not affect body weight, resting EE or skeletal muscle AMPK phosphorylation. Dogs fed MH had significantly lower post-prandial RQ (p = 0.02) and ratio of fat to lean body mass (p = 0.02). Physical activity during light time periods (but not dark) was lower in dogs fed MH (p < 0.05) during weekends, but not on weekdays. These results suggest that MH affects energy balance of adult dogs, but that these effects are not dose dependent and not due to physical activity.

Treatment of equine metabolic syndrome: A clinical case series

REASONS FOR PERFORMING STUDY

Treatment of equine metabolic syndrome (EMS) is essential to improve insulin sensitivity and reduce the risk of laminitis. Calorie restriction and increased exercise are the mainstays of treatment but there is potential for poor owner compliance.

OBJECTIVES

To determine whether significant weight loss accompanied by improvements in measures of insulin sensitivity can be achieved in horses and ponies with EMS managed by their owners in their normal environment under veterinary guidance.

STUDY DESIGN

Retrospective clinical case series.

METHODS

Horses and ponies attending 2 university hospitals for investigation and treatment of suspected EMS were eligible for inclusion in the study. Animals underwent a clinical examination, basal and dynamic endocrine testing; those with pituitary pars intermedia dysfunction (PPID) were excluded. Owners were given individually tailored diet and exercise programmes to follow for between 3 and 6 months. After the treatment period, clinical examination and endocrine tests were repeated and results compared to the initial assessment.

RESULTS

Nineteen animals were recruited to the study, 17 with a history of laminitis. All animals showed a reduction in body condition score (P<0.001) and 18/19 had a reduction in bodyweight (P<0.001) between assessments. There were significant (P<0.05) reductions in basal insulin, insulin at 45 min during a combined glucose insulin tolerance test (CGIT), time for blood glucose concentration to return to baseline during a CGIT and mean area under the glucose curve.

CONCLUSIONS

A diet and exercise programme tailored to the needs of the individual animal and implemented by the owner results in weight loss accompanied by improvements in insulin sensitivity.

Energy requirements of adult dogs: a meta-analysis

A meta-analysis was conducted to determine the maintenance energy requirements of adult dogs. Suitable publications were first identified, and then used to generate relationships amongst energy requirements, husbandry, activity level, methodology, sex, neuter status, dog size, and age in healthy adult dogs. Allometric equations for maintenance energy requirements were determined using log-log linear regression. So that the resulting equations could readily be compared with equations reported by the National Research Council, maintenance energy requirements in the current study were determined in kcal/kg(0.75) body weight (BW). Ultimately, the data of 70 treatment groups from 29 publications were used, and mean (± standard deviation) maintenance energy requirements were 142.8±55.3 kcal·kgBW(-0.75)·day(-1). The corresponding allometric equation was 81.5 kcal·kgBW(-0.9)·day(-1) (adjusted R2 = 0.64; 70 treatment groups). Type of husbandry had a significant effect on maintenance energy requirements (P<0.001): requirements were greatest in racing dogs, followed by working dogs and hunting dogs, whilst the energy requirements of pet dogs and kennel dogs were least. Maintenance energy requirements were less in neutered compared with sexually intact dogs (P<0.001), but there was no effect of sex. Further, reported activity level tended to effect the maintenance energy requirement of the dog (P = 0.09). This review suggests that estimating maintenance energy requirements based on BW alone may not be accurate, but that predictions that factor in husbandry, neuter status and, possibly, activity level might be superior. Additionally, more information on the nutrient requirements of older dogs, and those at the extremes of body size (i.e. giant and toy breeds) is needed.

Mannoheptulose has differential effects on fasting and postprandial energy expenditure and respiratory quotient in adult Beagle dogs fed diets of different macronutrient contents

The present study aimed to determine the effects of mannoheptulose (MH) (8 mg/kg) on energy expenditure (EE), respiratory quotient (RQ) and glycaemic response in healthy adult Beagle dogs (n 8; 9·62 (sem 0·31) kg; body condition score 4·5). The study was designed as replicated 4 × 4 Latin squares with a 2 × 2 factorial treatment structure. The dietary treatments were low carbohydrate (CHO) relative to fat diet (LC; 31 % CHO, 28 % fat) with placebo (0 mg/kg) or MH supplement and high CHO relative to fat diet (HC; 54 % CHO, 11 % fat) with placebo (0 mg/kg) or MH supplement. Dogs were fed to maintain body weight (HC and HC^+MH 3625 (sem 295) kJ and LC and LC^+MH 3542 (sem 284) kJ). Resting and postprandial (0–4 h; 5–10 h; 11–17 h; 18–23 h) EE and RQ were determined by indirect calorimetry (days 12 or 14). Glycaemic response to a meal (24 h) and plasma MH concentrations were determined on days 12 or 14. Plasma MH followed first-order kinetics, confirming that MH is absorbed and available to the animal. In the presence of high dietary CHO, MH increased postprandial EE (5–10 h only), suggesting MH increased dietary induced thermogenesis. In contrast to earlier reports, MH did not affect serum glucose or insulin in the present study. Irrespective of MH, dogs adapted RQ to diet composition and dogs consuming the LC diet had a greater incremental AUC for glucose, but not insulin, than dogs consuming the HC diet.

Portrayals of canine obesity in English-language newspapers and in leading veterinary journals, 2000-2009: implications for animal welfare organizations and veterinarians as public educators

In industrialized societies, more than 1 in 3 dogs and people currently qualify as overweight or obese. Experts in public health expect both these figures to rise. Although clinical treatment remains important, so are public perceptions and social norms. This article presents a thematic analysis of English-language mass media coverage on canine obesity from 2000 through 2009 and compares these results with a thematic analysis of articles on canine obesity in leading veterinary journals during the same time period. Drawing on Giddens's theory of structuration, this study identified articles that emphasized individual agency, environmental structure, or both as contributors to canine obesity. Comparisons with weight-related health problems in human populations were virtually absent from the veterinary sample. Although such comparisons were almost always present in the media sample, quotations from veterinarians and other spokespeople for the welfare of nonhuman animals emphasized the agency of individual caregivers (owners) over structural influences. Now that weight gain and obesity have been established as a pressing animal welfare problem, these results suggest a need for research and for interventions, such as media advocacy, that emphasize intersections between animal-owner agency, socioenvironmental determinants, and connections between animal welfare and human health.

Use of pedometers to measure the relationship of dog walking to body condition score in obese and non-obese dogs

The objective of the present study was to utilise an accurate canine pedometer methodology and to assess the relationship between activity and body condition score (BCS) in dogs. Initial methodology validation used videography and pedometer step measurements to assess actual steps taken in comparison with pedometer readings for twenty large, medium and small dogs. During the validation, dogs considered to be medium or large breed showed no significant difference between pedometer readings and actual steps taken. A total of seventy-seven obese and non-obese dogs over 35 cm (14 inches) shoulder height and over 10 kg were recruited from a dog obesity clinic and a community sample to assess daily walking activity. Body condition scoring and pedometer steps were assessed on three separate weeks during a 10-week period. During the activity monitoring, daily step counts ranged from 5555 to 39 970 steps/d among the seventy-seven medium and large dogs. Dogs' BCS were inversely correlated with average daily steps (Spearman's ρ = - 0.442, P < 0.0001). The present study identified a significant inverse correlation between daily walking steps and BCS over a range from 4 to 9 out of 9 (P < 0.0001).

Do feeding practices of obese dogs, before weight loss, affect the success of weight management?

Dietary factors (e.g. feeding treats and table scraps) can predispose to obesity in dogs, but it is not known whether they also influence success of weight loss. Therefore, the aim of the present study was to determine which pre-weight-loss factors were associated with outcome of their weight management regimen in dogs. Information from ninety-five dogs attending the Royal Canin Weight Management Clinic, University of Liverpool (Wirral, UK), was reviewed. The effect of different food types (e.g. dry, wet and home-prepared), feeding practices (e.g. method of portion size calculation and number of meals per day) and use of treats was assessed on outcome measures of the weight management regimen. Before weight loss, most owners (sixty-three out of ninety-five, 66 %) fed twice daily, used complete dry food (seventy-two out of ninety-five, 76 %) and calculated portion size either by measuring cup (thirty-six out of ninety-five, 38 %) or by visual estimation (thirty-seven out of ninety-five, 39 %). Feeding treats was common and included purchased treats (forty-one out of ninety-five, 43 %), table scraps (twenty-four out of ninety-five, 25 %), pet food (eighty-three out of ninety-five, 87 %) and human food (eighty-one out of ninety-five, 85 %). The majority of feeding practices did not influence any outcome measure for the weight-loss period (P>0·05 for all). However, metabolisable energy intake during weight loss was significantly higher in dogs fed dry food (P = 0·047) and lower in dogs fed purchased snacks before weight loss (P = 0·036). Thus, most pre-weight-loss factors have limited effect on outcomes of weight loss. The significance of the associations identified between feeding of dried food and purchased treats, and weight-loss energy intake, requires further study.

The relationship of feeding patterns and obesity in dogs

The rates of dog obesity are increasing and a greater understanding of feeding patterns is required to combat the problem. This study examined relationships between dietary patterns and caloric intake, and nutrient content of foods fed as it relates to obesity in dogs in the United States. Sixty-one owners and their dogs were enrolled, and lifestyle surveys, food frequencies, and 3-day food records were collected. Significant differences in overall kcal intake per kilogram of body weight were found (p< 0.04). Crude fibre in dog food was positively associated with protein and negatively associated with fat regardless of the dog's weight (p< 0.001). Lean dogs received significantly more crude fibre in relation to overweight dogs regardless of the number of treats they received (p< 0.01), and their diets had greater micronutrient densities (p< 0.03) suggesting that high fibre influences body condition. Additionally, owners who ate nutrient-rich, calorie-poor diets had normal weight dogs, and owners that fed more table scraps had overweight dogs. Regardless of body condition, 59% of dogs received table scraps, which constituted 21% of daily caloric intake. The nutrient density of scraps fed was variable and did not meet National Research Council's recommendations for micronutrient adequacy.