Use of reduced-energy content maintenance diets for modest weight reduction in overweight cats and dogs

One option for controlled weight loss for dogs and cats in overweight condition could be to modestly restrict caloric intake using a reduced-energy ('light') maintenance diet, but there is no prior research on the safety and efficacy of such an approach. A prospective observational cohort study was performed in 67 overweight dogs and 17 overweight cats undergoing weight loss using reduced-energy maintenance diets from one manufacturer. Diets were fed at approximately 80% of maintenance energy requirements for ideal bodyweight for a period of 8 weeks. Essential nutrient intake was estimated for each dog and cat and compared with minimum requirement (MR) or adequate intake (AI, when no MR had been demonstrated) as set by the National Research Council in 2006. Weight loss was seen in 56/67 dogs (84%), losing a median of 4.7% (range 15.2% loss to 10.0% gain) of their starting body weight (SBW). Weight loss was also seen in all 17 cats, losing a median of 6.4% (range 2.0 loss to 15.2% loss) of SBW. Of the essential nutrients examined, only selenium, choline, potassium, and riboflavin were less than NRC recommendations in a minority of animals. However, no signs of any nutrient deficiency were observed in any of the dogs or cats during the study. In summary, modestly energy restricting overweight dogs and cats when feeding a low-energy maintenance diet can induce weight loss and might be a useful initial step for weight management. Although no adverse effects were seen, borderline intake of some micronutrients warrants further consideration.

Narrative review of therapies for chronic enteropathies in dogs and cats

BACKGROUND

The optimal medical treatment for chronic enteropathy (CE) in dogs and cats is controversial. Sequential treatment using diet, antimicrobials, and immunosuppressive drugs is the most common strategy used by clinicians.

OBJECTIVES

To review the evidence for the effectiveness of dietary, drug, and alternative health interventions for inducing clinical remission in dogs and cats with CE.

ANIMALS

Retrospective study of dogs and cats with a diagnosis of chronic enteropathy.

METHODS

MEDLINE and Centre for Agriculture and Bioscience International (CABI) databases (1950 to March 2017) were searched for randomized controlled trials (RCTs), observational studies, and case series. The primary outcome was induction of clinical remission. All studies were evaluated using the quality of evidence grading guidelines (I-IV), which assign a score defining the strength and quality of the evidence.

RESULTS

Twenty-two studies (11 RCTs in dogs and 2 in cats and 9 cohort studies or case series) met the inclusion criteria for inducing remission of gastrointestinal (GI) signs. Of the 13 RCTs achieving grade I scores, 10 studies (totaling 218 dogs and 65 cats) compared single treatment: diet (n = 3), immunosuppressives (n = 3), antimicrobials (n = 2), anti-inflammatory drugs (n = 1), and probiotics (n = 1). Three case series (grade III) reported clinical remission using an elimination diet fed to 55 cats and use of enrofloxacin to induce remission in dogs with granulomatous colitis (2 studies totaling 16 dogs).

CONCLUSIONS AND CLINICAL IMPORTANCE

The current evidence for treatment of CE is much greater in dogs than in cats. There is sufficient strong evidence to recommend the use of therapeutic GI diets, glucocorticoids, enrofloxacin, or some combination of these in dogs with CE. Therapeutic GI diets and glucocorticoids are most useful in cats with CE.

Factors associated with overweight cats successfully completing a diet-based weight loss programme: an observational study

BACKGROUND

The most common approach for controlled weight loss in cats is dietary caloric restriction, using a purpose-formulated diet. Most previous studies have only assessed short-term outcomes, and no previous study has examined overall success (i.e. odds of reaching target weight). The aim of this study was to determine the factors associated with overweight cats successfully completing a diet-based weight loss programme to reach target weight.

RESULTS

Sixty-two cats were included, and 28 (45%) completed their weight loss programme. The remaining 34 cats (55%) did not reach target weight, of which 2 (3%) were euthanised for unrelated reasons. Reasons for cats stopping the programme prematurely included inability to contact owner (n = 19), owner requested that the programme be completed prior to reaching target weight (n = 5), the cat developed another illness (n = 3), refusal to comply with requirements for weight management (n = 2), owner illness (n = 2), and personal issues of the owner (n = 1). Multiple logistic regression analysis revealed that rate of weight loss and weight loss required were positively (odds ratio [OR] 157.81, 95% confidence interval [CI] 10.00-2492.67) and negatively (OR 0.89, 95% CI 0.81-0.98) associated with the odds of completing the weight loss programme, respectively.

CONCLUSIONS

Future studies should consider developing better methods of supporting the owners of the most obese cats during weight management, since these cats are least likely to complete reach target weight.

A nutraceutical diet based on Lespedeza spp., Vaccinium macrocarpon and Taraxacum officinale improves spontaneous feline chronic kidney disease

Chronic kidney disease is characterized by structural and/or functional impairment of one or both kidneys persisting for more than 3 months. In cats, chronic kidney disease can frequently occur in animals aged over 9 years with an incidence of approximately 10%. Thirty-four client-owned, neutered cats, suffering from stage II-III chronic kidney disease and diagnosed according to the International Renal Interest Society guidelines were randomly assigned to receive either a control diet (n = 17) or a nutraceutical diet (ND; n = 17) for 90 days. Both diets were commercialized for management of CKD symptoms. The diets were identical except that the ND contained tablets that consisted of 60-80% hydrolysed proteins, 20-40% minerals and active substances, that are, Lespedeza spp. 0.0588%, Vaccinium macrocarpom 0.0371%, and Taraxacum officinale 0.0231%. No adverse effects were reported during this study. Both diets resulted in an improvement in CKD symptoms. After a 90-day evaluation, creatinine, blood urea nitrogen, total proteins, and aspartate aminotransferase significantly decreased in cats that received the ND. A significant decrease was also observed in urine turbidity score, color score, and total proteins in cats that received the ND. We have found that a ND based on Lespedeza spp., Vaccinium macrocarpon, and Taraxacum officinale improves key indicators of renal failure in cats affected by chronic kidney disease.

Effects of weight loss with a moderate-protein, high-fiber diet on body composition, voluntary physical activity, and fecal microbiota of obese cats

OBJECTIVE To determine effects of restriction feeding of a moderate-protein, high-fiber diet on loss of body weight (BW), voluntary physical activity, body composition, and fecal microbiota of overweight cats. ANIMALS 8 neutered male adult cats. PROCEDURES After BW maintenance for 4 weeks (week 0 = last week of baseline period), cats were fed to lose approximately 1.5% of BW/wk for 18 weeks. Food intake (daily), BW (twice per week), body condition score (weekly), body composition (every 4 weeks), serum biochemical analysis (weeks 0, 1, 2, 4, 8, 12, and 16), physical activity (every 6 weeks), and fecal microbiota (weeks 0, 1, 2, 4, 8, 12, and 16) were assessed. RESULTS BW, body condition score, serum triglyceride concentration, and body fat mass and percentage decreased significantly over time. Lean mass decreased significantly at weeks 12 and 16. Energy required to maintain BW was 14% less than National Research Council estimates for overweight cats and 16% more than resting energy requirement estimates. Energy required for weight loss was 11% more, 6% less, and 16% less than American Animal Hospital Association recommendations for weight loss (80% of resting energy requirement) at weeks 1 through 4, 5 through 8, and 9 through 18, respectively. Relative abundance of Actinobacteria increased and Bacteroidetes decreased with weight loss. CONCLUSIONS AND CLINICAL RELEVANCE Restricted feeding of a moderate-protein, high-fiber diet appeared to be a safe and effective means for weight loss in cats. Energy requirements for neutered cats may be overestimated and should be reconsidered.

Therapeutic effects of an alpha-casozepine and L-tryptophan supplemented diet on fear and anxiety in the cat

Objectives This study assessed the anxiolytic effectiveness of a test diet (Royal Canin Feline Calm diet) supplemented with L-tryptophan and alpha-casozepine. Methods Subjects were 24 cats that were classified as mildly or markedly fearful based on the presence of a person in their home room. Three different protocols were used to assess anxiety: (1) evaluation of the response to a human in the cat's home room (home room test); (2) analysis of the response to placement in an empty test room (open-field test); and (3) analysis of the response to an unfamiliar human (human interaction test). All three protocols were first run at baseline, and the results were used to assign the animals to control and test diet groups that showed equivalent fear and anxiety. Both groups were retested on the three protocols after 2 weeks (test 1) and again after 4 weeks (test 2). Results The diet groups differed for two behavioral measures in the open-field test: inactivity duration and inactivity frequency. The control group showed statistically significant increases in inactivity duration between baseline and test 1 and baseline and test 2, while the group fed the test diet showed a marginally not significant decrease in inactivity duration between baseline and test 1 and a not significant decrease for test 2. There was also a significant increase in inactivity frequency between baseline and test 1 in the test diet group and marginally not significant decrease in the control group. There were no differences between groups in the approach of the cats toward people for the home room test and the human interaction test. Conclusions and relevance These results suggest that the test diet reduced the anxiety response to placement in an unfamiliar location, but that fear in the presence of an unfamiliar person was not counteracted by the diet.

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.

Impact of time-limited feeding and dietary carbohydrate content on weight loss in group-housed cats

Twenty-four adult cats were transitioned to time-limited feeding and randomized to either a dry low carbohydrate diet (LC) or a dry reduced energy diet (HC). In Trial 1 the LC and HC groups received equal amounts of food (by weight) for 13 weeks. Both groups consumed all food offered, hence the LC group received more energy/day than the HC group. In Trial 2 all cats were fed the LC diet for 12 weeks, but each group received the energy that the opposite group had received in Trial 1. In Trial 1 only the overweight HC cats (body condition score>6/9) experienced a significant change in body weight (−0.52±0.08 kg). In Trial 2, LC/Low Calorie overweight cats lost 0.62±0.10 kg, whereas, the LC/High Calorie normal weight cats gained 0.68±0.05 kg. In conclusion, body condition and energy intake but not type of diet influenced weight in this cohort of group-housed cats.

Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis

This prospective observational study evaluated client-reported recurrence of lower urinary tract signs (LUTS) and other signs of abnormalities in cats with idiopathic cystitis after institution of multimodal environmental modification (MEMO). Forty-six client-owned indoor-housed cats with idiopathic cystitis, diagnosed based on a history of recurrent LUTS and evidence of absence of urolithiasis or bacterial urinary tract infection were studied. In addition to their usual care, clients were offered recommendations for MEMO based on a detailed environmental history. Cases were followed for 10 months by client contact to determine the effect of MEMO on LUTS and other signs. Significant ( P<0.05) reductions in LUTS, fearfulness, nervousness, signs referable to the respiratory tract, and a trend ( P<0.1) toward reduced aggressive behavior and signs referable to the lower intestinal tract were identified. These results suggest that MEMO is a promising adjunctive therapy for indoor-housed cats with LUTS, and should be followed up with prospective controlled clinical trials.

Comparison of foods with differing nutritional profiles for long-term management of acute nonobstructive idiopathic cystitis in cats

OBJECTIVE

To evaluate the effect of nutrition on recurrent clinical signs of lower urinary tract (LUT) disease in cats with idiopathic cystitis.

DESIGN

Randomized, controlled, masked clinical trial.

ANIMALS

31 cats with acute nonobstructive idiopathic cystitis.

PROCEDURES

Cats were assigned to receive 1 of 2 foods (a cystitis prevention or control food) that differed in mineral (calcium, phosphorous, and magnesium), antioxidant, and fatty acid profiles. Owners documented LUT signs daily for up to 1 year. The primary endpoint was the number of recurrent episodes in which a cat had multiple (≥ 2 concurrent) LUT signs within a day (defined as multiple-sign day). Consecutive days in which a cat had multiple LUT signs were considered as a single episode.

RESULTS

4 cats fed prevention food and 2 cats fed control food were excluded from analysis because of noncompliance, gastrointestinal signs, food refusal, or owner voluntary withdrawal. The proportion of cats fed prevention food that had ≥ 1 recurrent episode of multiple-sign days (4/11) was not significantly lower than that of cats fed control food (9/14). However, cats fed prevention food had significantly lower mean incidence rates for recurrent episodes of multiple-sign days (0.7 episodes/1,000 cat-days) and episodes of hematuria (0.3 episodes/1,000 cat-days), dysuria (0.2 episodes/1,000 cat-days), and stranguria (0.2 episodes/1,000 cat-days) as single LUT signs, compared with cats fed control food (5.4, 3.4, 3.1, and 3.8 episodes/1,000 cat-days, respectively). Significantly fewer cats fed prevention food required analgesics (4/11), compared with cats fed control food (12/14).

CONCLUSIONS AND CLINICAL RELEVANCE

Foods with differing nutritional profiles appeared to impact mean incidence rates of recurrent feline idiopathic cystitis-associated signs.

Effect of feeding a weight loss food beyond a caloric restriction period on body composition and resistance to weight gain in cats

OBJECTIVE

To determine the effect of feeding a food with coconut oil and supplemental L-carnitine, lysine, leucine, and fiber on weight loss and maintenance in cats.

DESIGN

Prospective clinical study.

ANIMALS

50 overweight cats.

PROCEDURES

The study consisted of 2 trials. During trial 1, 30 cats were allocated to 3 groups (10 cats/group) to be fed a dry maintenance cat food to maintain body weight (group 1) or a dry test food at the same amount on a mass (group 2) or energy (group 3) basis as group 1. During trial 2, each of 20 cats was fed the test food and caloric intake was adjusted to maintain a weight loss rate of 1%/wk (weight loss phase). Next, each cat was fed the test food in an amount calculated to maintain the body weight achieved at the end of the weight loss phase (weight maintenance phase). Cats were weighed and underwent dual-energy x-ray absorptiometry monthly. Metabolomic data were determined before (baseline) and after each phase.

RESULTS

During trial 1, cats in groups 2 and 3 lost significantly more weight than did those in group 1. During trial 2, cats lost a significant amount of body weight and fat mass but retained lean body mass during the weight loss phase and continued to lose body weight and fat mass but gained lean body mass during the weight maintenance phase. Evaluation of metabolomic data suggested that fat metabolism was improved from baseline for cats fed the test food.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that feeding overweight cats the test food caused weight loss and improvements in body condition during the weight maintenance phase, possibly because the food composition improved energy metabolism.

Assessment of protein and amino acid concentrations and labeling adequacy of commercial vegetarian diets formulated for dogs and cats

OBJECTIVE

To determine measured crude protein (CP) and amino acid (AA) concentrations and assess labeling adequacy of vegetarian diets formulated for dogs and cats.

DESIGN

Cross-sectional study.

SAMPLE

13 dry and 11 canned vegetarian diets for dogs and cats.

PROCEDURES

Concentrations of CP and AAs were determined for each diet. Values were compared with the Association of American Feed Control Officials (AAFCO) Dog and Cat Food Nutrient Profiles. Product labels were assessed for compliance with AAFCO regulations.

RESULTS

CP concentration (dry-matter basis) ranged from 19.2% to 40.3% (median, 29.8%). Minimum CP concentrations for the specified species and life stage were met by 23 diets; the remaining diet passed appropriate AAFCO feeding trials. Six diets did not meet all AA minimums, compared with the AAFCO nutrient profiles. Of these 6 diets, 1 was below AAFCO minimum requirements in 4 AAs (leucine, methionine, methionine-cystine, and taurine), 2 were below in 3 AAs (methionine, methionine-cystine, and taurine), 2 were below in 2 AAs (lysine and tryptophan), and 1 was below in 1 AA (tryptophan). Only 3 and 8 diets (with and without a statement of calorie content as a requirement, respectively) were compliant with all pet food label regulations established by the AAFCO.

CONCLUSION AND CLINICAL RELEVANCE

Most diets assessed in this study were not compliant with AAFCO labeling regulations, and there were concerns regarding adequacy of AA content. Manufacturers should ensure regulatory compliance and nutritional adequacy of all diets, and pets fed commercially available vegetarian diets should be monitored and assessed routinely.

Critically appraised topic on adverse food reactions of companion animals (2): common food allergen sources in dogs and cats

BACKGROUND

To diagnose cutaneous adverse food reactions (CAFRs) in dogs and cats, dietary restriction-provocation trials are performed. Knowing the most common offending food allergens for these species would help determining the order of food challenges to optimize the time to diagnosis.

RESULTS

The search for, and review and analysis of the best evidence available as of January 16, 2015 suggests that the most likely food allergens contributing to canine CAFRs are beef, dairy products, chicken, and wheat. The most common food allergens in cats are beef, fish and chicken.

CONCLUSIONS

In dogs and cats, after a period of dietary restriction leading to the complete remission of clinical signs, food challenges to diagnose CAFR should begin with beef and dairy products, the most commonly recognized food allergens in these two species.

Clinical Nutrition in Gerontology: Chronic Renal Disorders of the Dog and Cat

The recent advances in the nutrition of companion animals has resulted in a longer possible life-span for dogs and cats and an improvement in their quality of life. Numerous studies about geriatric animals show that an aging dog or cat requires a specific nutritional formulation that considers the metabolic changes associated with age. A correct diet plays an important role in the treatment of some chronic pathologies in aging animals, particularly those for which the aging process modifies the organ function. A correct diet can provide therapeutic support to the administration of drugs that can sometimes compromise organ function. In the present study, we identify key aspects of the clinical nutrition during chronic renal disorders of dogs and cats, diseases with an elevated incidence and a major cause of mortality in geriatric animals. The aim of nutritional treatment for dogs and cats affected by chronic renal disorders is to improve the quality and length of life, assuring an adequate amount of energy and slowing the progression of renal failure. To improve treatment efficacy it is necessary to prepare different dietary rations during the various stages of disease, on the basis of clinical signs and laboratory data.

Fecal microbiota of cats with naturally occurring chronic diarrhea assessed using 16S rRNA gene 454-pyrosequencing before and after dietary treatment

BACKGROUND

The gastrointestinal (GI) microbiota has a strong impact on the health of cats and these populations can be altered in GI disease. Little research has been done to associate improvement in diarrhea with changes in GI microbiota.

OBJECTIVE

To evaluate GI microbiota changes associated with diet change and related improvement in diarrhea in cats with chronic naturally occurring diarrhea.

ANIMALS

Fifteen adult Domestic Shorthair cats with naturally occurring chronic diarrhea.

METHODS

Controlled crossover dietary trial for management of diarrhea. Fecal microbiome was assessed using 454-pyrosequencing. Relationships among fecal score (FS), diet, and microbiome were explored using partial least square method, partial least square method - discriminant analysis, and orthogonal partial least square method with discriminant analysis (OPLS-DA).

RESULTS

Dominant bacterial phyla included the Firmicutes and Bacteroidetes, followed by Fusobacteria, Proteobacteria, Tenericutes, and Actinobacteria. Orthogonal partial least squares (OPLS-DA) clustering showed significant microbial differences within cats when fed Diet X versus Diet Y, and with Diet Y versus baseline. Significant correlations were found between the microbiome and FSs. Those bacteria with the strongest correlation with FS included Coriobacteriaceae Slackia spp., Campylobacter upsaliensis, Enterobacteriaceae Raoultella spp., Coriobacteriaceae Collinsella spp., and bacteria of unidentified genera within the families of Clostridiales Lachnospiracea and Aeromonadales Succinivibrionacease, suggesting that increased numbers of these organisms may be important to gut health.

CONCLUSIONS AND CLINICAL IMPORTANCE

Alterations in intestinal microbiota were associated with improvement in diarrhea, but, from our data we cannot conclude if changes in the microbiome caused the improvement in diarrhea, or vice versa.

Focus on nutrition: dietary management of gastrointestinal disease

Nutrition plays a key role in the management of gastrointestinal disease, and some patients may be managed by dietary therapy alone. Dietary ingredients can have a negative or positive effect on the bowel. Negative factors in a diet may include toxins, allergens, toxic dietary excesses, or nutritional deficiencies. Diet also has a direct effect on intestinal physiology, affecting motility, cell renewal rate, intestinal microbiome, enzyme production, ammonia production, and volatile fatty acid content. This article discusses dietary therapy of acute gastroenteritis, chronic gastroenteropathies, and feline constipation.

Efficacy of a commercial hydrolysate diet in eight cats suffering from inflammatory bowel disease or adverse reaction to food

Eight of 28 cats presenting with chronic vomiting and/or diarrhoea were diagnosed as suffering from chronic enteropathy. All cats had undergone a complete diagnostic work-up, including endoscopy. Histopathology findings varied from normal, eosinophilic, to lymphoplasmacytic gastroenteritis. On the basis of findings, the cats were diagnosed with inflammatory bowel disease (IBD) or an adverse reaction to food. A hydrolysed protein diet was used as sole therapy, and clinical signs resolved within 4-8 days in all eight cats. After 2 months the cats had gained weight. A challenge trial with their previous diet resulted in recurrence of the clinical signs, which resolved in seven cats when the test diet was reintroduced. We conclude that the hydrolysed protein diet used in the current study was effective in managing these cases.

Focus on nutrition: antioxidants in cancer treatment: helpful or harmful?

Nutrition is an important component of the care of dogs and cats with cancer, and dietary supplement use is common in this patient population. Antioxidants are thought to be among the most commonly used supplements. While antioxidants have potential benefits for cancer patients, they also may have detrimental effects. Therefore, information regarding the overall diet, including dietary supplements, should be collected for every cancer patient and carefully assessed, with specific attention to antioxidants, to identify areas in which the patient's medical care can be optimized.

Nutritional considerations for animals with pulmonary disease

Recent publications in the human and veterinary literature have indicated that patients with pulmonary disease require specific nutritional consideration to ensure that optimal benefit is derived with nutrition support. Although additional research is needed in this area, preliminary recommendations can be made using information from the scant studies performed thus far in veterinary medicine and from information extrapolated from the human literature. These recommendations are likely to provide significant clinical benefit to patients with pulmonary disease. This article aims to provide the reader with a summary of the available information and links to other relevant sources.

Feline chronic renal failure: long-term medical management

Chronic renal failure (CRF) is one of the most common illnesses of geriatric cats. Common clinical signs include polydipsia, polyuria, decreased appetite, weight loss, and vomiting. Although CRF is incurable, it may be possible to delay the progression of the disorder by feeding an appropriate diet and by monitoring and normalizing (if possible) several parameters, including blood pressure, serum phosphorus and potassium levels, parathyroid hormone levels, and proteinuria.

A case-control study of the effects of nephrolithiasis in cats with chronic kidney disease

OBJECTIVE

To determine whether nephrolithiasis was associated with an increase in mortality rate or in the rate of disease progression in cats with naturally occurring stage 2 (mild) or 3 (moderate) chronic kidney disease.

DESIGN

Retrospective case-control study.

ANIMALS

14 cats with stage 2 (mild) or 3 (moderate) chronic kidney disease (7 with nephroliths and 7 without).

PROCEDURES

All cats were evaluated every 3 months for up to 24 months. Possible associations between nephrolithiasis and clinicopathologic abnormalities, incidence of uremic crises, death secondary to renal causes, and death secondary to any cause were evaluated.

RESULTS

There were no clinically important differences in biochemical, hematologic, or urinalysis variables between cats with and without nephroliths at baseline or after 12 and 24 months of monitoring. No associations were detected between nephrolithiasis and rate of disease progression, incidence of uremic crises, or death.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that in cats with mild or moderate chronic kidney disease, nephrolithiasis was not associated with an increase in mortality rate or in the rate of disease progression. Findings support recommendations that cats with severe kidney disease and nephrolithiasis be managed without surgery.

Nutrition and lower urinary tract disease in cats

Lower urinary tract disease occurs commonly in cats and is often associated with crystal-related disease. Dietary modification is beneficial in managing some of these diseases, including idiopathic cystitis, urolithiasis, and urethral matrix-crystalline plugs. Altering dietary formulation may result in decreasing urinary concentrations of crystallogenic compounds, increasing urinary concentrations fo crystallogenic inhibitors, and diluting urine composition.

Feline diabetes mellitus: low carbohydrates versus high fiber?

Treatment of diabetes mellitus (DM) in the cat relies primarily on the adequate insulin therapy and controlled dietary intake. The goals of managing DM in the cat have changed from attaining glycemic control to achieving diabetic remission (transient diabetes) in a large proportion of cases. Remission rates of up to 68% have been published. The used of low-carbohydrate foods for cats improves the odds of achieving diabetic remission by fourfold. Nonetheless, some cats show an improved response to high-fiber food. Clinical judgement, trial, and personal preference to currently dictate which diet to offer an individual animal.

Nutritional Management of Chronic Renal Disease in Dogs and Cats

Chronic renal disease is a leading cause of death in dogs and cats. Recent clinical studies show that nutrition plays a key role in improving quality of life and life expectancy of these patients. Typical nutritional interventions include modifying the protein, phosphorus, and lipid concentrations. Nutritional therapy, however, does not simply mean changing the diet; consideration must also be given to ensuring adequate caloric intake and to the method of feeding. Monitoring the effects of the dietary therapy is also crucial to ensure that the patients are responding appropriately to the selected nutritional modifications. Nutritional management must be coordinated with medical management for long term successful treatment.

Hydrolyzed Protein Diets for Dogs and Cats

The primary aim of a hydrolyzed protein diet is to disrupt the proteins within the diet sufficiently to remove existing allergens. Published assessment of hydrolyzed protein diets includes physiochemical and immunologic assays as well as nutritional and clinical feeding trials. Potential problems include poor palatability, hypoosmotic diarrhea, and a reduced nutritional value, although persistent allergenicity is the most significant. The primary indications for a hydrolyzed protein diet are use in elimination trials for the diagnosis of adverse food reactions, and the initial management of inflammatory bowel disease. Initial studies of hydrolyzed diet efficacy are encouraging. Consideration of the source ingredients should be given when using hydrolyzed protein diets in elimination feeding trials because antigenic sites may not be fully destroyed.

Understanding and Managing Obesity in Dogs and Cats

Treatment of diabetes mellitus (DM) is a common disease, and nutrition has become an integral part of management. This article focuses on the role of nutrition and dietary ingredients in OA, evaluating current evidence for obesity management, omega-3 fatty acids, and chondromodulating agents. Additionally, Keeping an animal in optimal to slightly lean body condition has been shown to decrease the risk of development of OA and to aid in management of dogs with OA.

Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats

Objective-To determine whether a renal diet modified in protein, phosphorus, sodium, and lipid content was superior to an adult maintenance diet in minimizing uremic episodes and mortality rate in cats with stage 2 or 3 chronic kidney disease (CKD). Design-Double-masked, randomized, controlled clinical trial. Animals-45 client-owned cats with spontaneous stage 2 or 3 CKD. Procedures-Cats were randomly assigned to an adult maintenance diet (n = 23 cats) or a renal diet (22) and evaluated trimonthly for up to 24 months. Efficacy of the renal diet, compared with the maintenance diet, in minimizing uremia, renal-related deaths, and all causes of death was evaluated. Results-Serum urea nitrogen concentrations were significantly lower and blood bicarbonate concentrations were significantly higher in the renal diet group at baseline and during the 12- and 24-month intervals. Significant differences were not detected in body weight; Hct; urine protein-to-creatinine ratio; and serum creatinine, potassium, calcium, and parathyroid hormone concentrations. A significantly greater percentage of cats fed the maintenance diet had uremic episodes (26%), compared with cats fed the renal diet (0%). A significant reduction in renal-related deaths but not all causes of death was detected in cats fed the renal diet. Conclusions and Clinical Relevance-The renal diet evaluated in this study was superior to an adult maintenance diet in minimizing uremic episodes and renalrelated deaths in cats with spontaneous stage 2 or 3 CKD.

Idiopathic megaoesophagus and intermittent gastro-oesophageal intussusception in a cat

An eight-month-old domestic shorthair cat was presented with chronic vomiting for three months, with an acute increase in frequency during the past two days. A diagnosis of megaoesophagus was made by chest radiography. Diagnostic work-up for megaoesophagus was performed. A gastro-oesophageal intussusception was identified during endoscopy. Medical and nutritional therapy was instituted with a good response to the treatment.

Disease prevalence among dogs and cats in the United States and Australia and proportions of dogs and cats that receive therapeutic diets or dietary supplements

OBJECTIVE

To estimate disease prevalence among dogs and cats in the United States and Australia and proportions of dogs and cats that receive therapeutic diets or dietary supplements.

DESIGN

Telephone survey. Sample Population-Dog and cat owners located in 5 geographic areas.

PROCEDURES

A telephone survey was administered to dog and cat owners.

RESULTS

Of 18,194 telephone calls that were made, 1,104 (6%) were to individuals who owned at least 1 dog or cat and agreed to participate. Information was collected for 635 dogs and 469 cats. Only 14 (1%) respondents indicated that their pet was unhealthy, but 176 (16%) indicated that their pets had 1 or more diseases. The most common diseases were musculo-skeletal, dental, and gastrointestinal tract or hepatic disease. Many owners (n = 356) reported their pets were overweight or obese, but only 3 reported obesity as a health problem in their pets. Owners of 28 (2.5%) animals reported that they were feeding a therapeutic diet, with the most common being diets for animals with renal disease (n = 5), reduced-calorie diets (5), and reduced-fat diets (4). Owners of 107 of 1,076 (9.9%) animals reported administering dietary supplements to their pets. Multivitamins (n = 53 animals), chondroprotective agents (22), and fatty acids (13) were the most common dietary supplements used.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that most dogs and cats reported by their owners to have a health problem were not being fed a therapeutic diet. In addition, the rate of dietary supplement use was lower than that reported for people.

Comparison of a low carbohydrate-low fiber diet and a moderate carbohydrate-high fiber diet in the management of feline diabetes mellitus

This study compared the effects of a moderate carbohydrate-high fiber (MC-HF) food and a low carbohydrate-low fiber (LC-LF) food on glycemic control in cats with diabetes mellitus. Sixty-three diabetic cats (48 male castrated, 15 female spayed) were randomly assigned to be fed either a canned MC-HF (n = 32) food or a canned LC-LF (n = 31) food for 16 weeks. Owners were blinded to the type of diet fed. CBC, urinalysis, serum chemistry panel, fructosamine concentration and thyroxine concentration were determined on initial examination, and a complete blood count, serum chemistry panel, urinalysis and serum fructosamine concentration were repeated every 4 weeks for 16 weeks. Insulin doses were adjusted as needed to resolve clinical signs and lower serum fructosamine concentrations. Serum glucose (P = 0.0001) and fructosamine (P = 0.0001) concentrations significantly decreased from week 0 to week 16 in both dietary groups. By week 16, significantly more of the cats fed the LC-LF food (68%, 22/31), compared to the cats fed the MC-HF food (41%, 13/32), had reverted to a non-insulin-dependent state (P = 0.03). Cats in both groups were successfully taken off of insulin regardless of age, sex, type of insulin administered or duration of clinical disease before entering the study. There was no significant difference in the initial or final mean body weights or in the mean change in body weight from week 0 to week 16 between dietary groups. Diabetic cats in this study were significantly more likely to revert to a non-insulin-dependent state when fed the canned LC-LF food versus the MC-HF food.

Retrospective study of the survival of cats with acquired chronic renal insufficiency offered different commercial diets

A retrospective study was carried out on the efficacy of seven commercial diets designed to be fed to cats with chronic renal failure. The median survival time of 175 cats that received conventional diets was seven months, whereas the median survival time of 146 cats given one of the seven diets was 16 months. The cats on the most effective of the diets had a median survival time of 23 months and those on the least effective diet had a median survival time of 12 months. The composition of the seven diets was comparable, except that the most effective diet had a particularly high content of eicosapentaenoic acid.

Hypervitaminosis A in the cat: a case report and review of the literature

A case of hypervitaminosis A with secondary entrapment and compression of the left brachial plexus nerve roots is described. A 9-year-old male castrated domestic shorthair, fed a home-made diet based on raw pork liver, was submitted for examination for a left forelimb lameness that evolved to paralysis over a 2-month period. Clinical examination revealed a flaccid paralysis and atrophy of all left forelimb muscles. An ipsilateral Horner's syndrome was also noted. Radiological examination of the cervical and thoracic spine showed massive new bone formation at the ventral aspect of the second cervical to sixth thoracic vertebra. The diagnosis of hypervitaminosis A was made, based on the clinical and radiographic findings, as well as the determination of serum vitamin A concentration, which was 630 microg/dl, three times above the upper normal limit for this species. Despite the unfavourable initial prognosis, the cat progressively regained function of the affected limb approximately 6 months after the diet was changed to a commercial canned food.

Calcinosis involving multiple paws in a cat with chronic renal failure and in a cat with hyperthyroidism

Calcinosis of multiple paws is described in two cats. A metastatic pathogenesis was supported by the laboratory findings of hyperphosphataemia and a calcium x phosphorus solubility product > 7 g/L. Hyperparathyroidism could not be confirmed because a valid feline parathyroid hormone assay was not available at the time. One cat was diagnosed with chronic renal failure and presented initially with an irregular nodular calcification on the chin. Dietary and medical management was unsuccessful and ultimately the animal was euthanased. Hyperthyroidism was diagnosed in another cat by laboratory findings and scintigraphic imaging. In addition, the cat had a hyperphosphataemia in the absence of azotaemia. Intravenous administration of radioactive iodine as (131)I was accompanied by reduction and normalization in serum total thyroxine and phosphorus concentrations and resulted in resolution of calcification in the paws.

[Comparative analysis of commercial renal diets for cats, with emphasis on their fatty acid composition]

The objective of this study was to compare renal diets for cats that are commercially available in The Netherlands. The diets were analysed and their composition compared with a guideline proposed by the authors. Special attention was paid to the fatty acid composition of the diets and the role of fatty acids in the progression of chronic renal failure. On the basis of a total score for nutrient levels relative to the guideline recommendations, the diets were ranked as to expected efficacy.

Effects of Diet on Urine Composition of Cats With Calcium Oxalate Urolithiasis

Ten client-owned cats with calcium oxalate (CaOx) urolithiasis were evaluated to determine the effect of diet on urine CaOx saturation. Two dietary treatments were evaluated in each cat: the diet consumed just prior to urolith detection and a canned diet formulated to prevent CaOx uroliths. This study revealed that hypercalciuria is a consistent abnormality in cats with CaOx urolith formation. When urolith-forming cats consumed a diet formulated to prevent urolith formation, activity product ratios for CaOx (which estimate the degree to which urine is saturated with CaOx) were significantly lower. These results suggest that consumption of an appropriately formulated urolith-prevention diet will reduce recurrence of CaOx urolithiasis.

Evaluation of two diets in the nutritional management of cats with naturally occurring chronic diarrhea

Feeding either a highly digestible, moderate-carbohydrate diet or a highly digestible, high-protein, low-carbohydrate diet resulted in significant (P < .05) improvements in fecal scores in 71% of cats with chronic, nonspecific diarrhea. Approximately 58% of the cats improved on either diet, with no significant differences between the two diets regarding the percentage of cats responding or the degree of response. These results suggest that dietary management may be helpful in cats with chronic diarrhea. If cats do not respond within 1 month, an alternative diet should be considered.

Evaluation of the efficacy of a commercial diet in the dissolution of feline struvite bladder uroliths

Clinical signs of struvite urolithiasis resolved in an average of 19 days in cats fed either a canned or dry urine-acidifying, magnesium-restricted diet, and stones completely dissolved in 31 of 39 cats in an average of 30 days. Stones were surgically removed from five cats, and analysis revealed that these stones were not composed of struvite. The results of this study strongly suggest that the diet will dissolve naturally occurring feline struvite bladder uroliths.

The medical management of idiopathic chylothorax in a domestic long-haired cat

A 3-year-old, spayed female domestic long-hair was evaluated for a 2-week history of progressive tachypnea. Chylothorax was diagnosed through radiographic and pleural fluid evaluation. No primary cause was identified and the cat was managed medically. Thoracocentesis, dietary management, and oral rutin therapy resulted in substantial improvement of this idiopathic condition.

Nutritional management of gastrointestinal disease

The gastrointestinal (GI) tract is primarily responsible for acquiring and digesting food, absorbing nutrients and water, and expelling wastes from the body as feces. A proper diet and normally functioning GI tract are integral for the delivery of nutrients, prevention of nutrient deficiencies and malnutrition, repair of damaged intestinal epithelium, restoration of normal luminal bacterial populations, promotion of normal GI motility, and maintenance of normal immune functions (eg, both tolerance and protection from pathogens). The amount of food, its form, the frequency of feeding, and the composition of diet each have important effects on GI function and may be used to help ameliorate signs of GI disease. Although both nutrients and nonnutritional components of a diet are important to GI health, they also may cause or influence the development of GI pathology (eg, antibiotic responsive diarrhea, inflammatory bowel disease, dietary intolerance, or sensitivity and/or allergy). The appropriate diet may have a profound effect on intestinal recovery and successful management of chronic or severe GI disease.