san ecalcs & ls ls
DESCRIPTION
VTS150--AldenTRANSCRIPT
The Iterative ProcessTwo step clinical
nutrition process
Step 1: Assess the patient, food and feeding method
Step 2: Develop feeding plan including food choice and feeding method
Animal
Food
FeedingMethod
ASSESSMENT
Food
FeedingMethod
FEEDING PLAN
Iterative ProcessFactors in Patient Assessment
Signalment: species, breed, age, gender, neuter status, activity level, environment
Medical History: medical conditions, vaccines, surgeries, medications
Diagnostics: blood chemistry, radiographs
Physical Exam: abnormalities, BCS
Body Condition ScoringSubjective method of assessing an animal’s fat stores
Fat cover is evaluated over the ribs, down the topline, around the tail base and along the abdomen
1 2 4 5
EMACIATED THIN
3
IDEAL OVERWEIGHT OBESE
PALPATION IS KEY!
© Hill’s Pet Nutrition, Inc.
Body Condition Scoring
© Hill’s Pet Nutrition, Inc.
Body Condition Scoring
Iterative Process: Dietary History
What Do You Need to Know About the Animal’s Dietary History?
Brand of Food Form of Food Feeding Method & Frequency Treats?
Table food?…
Review of Nutrients• Water• Carbohydrates• Protein• Fat• Minerals• Vitamins• Antioxidants*
EnergyProducingNutrients
Review of Basic Nutrients:WaterDogs & Cats meet most water requirements
through food and drink
Amount required varies: Type of food Activity Life Stage
Review of Basic Nutrients:Water
As fed Nutrients are calculated as a
percentage of the product including
water
Dry matter basisNutrients are calculated as a
percentage of the product without the
water
Vs.
Nutrients in food…
Which Has More Protein?Moist Product 75% moisture 10% protein 8% fat 9% CHO
Dry Product 10% moisture 18% protein 12% fat 32% CHO
Review of Basic Nutrients:Water
Moist Product – as fed 75% moisture 10% protein 8% fat 9% CHO
For Moist Products the percentage of nutrients on a Dry Matter Basis (DMB)
equals approximately 4x the percent on an as fed basis
This product contains ~40% protein DMB
Review of Basic Nutrients:Water
Dry Product – as fed• 10% moisture• 18% protein• 12% fat• 32% CHO
For Dry Products the percentage of nutrients on a Dry Matter Basis equals approximately
10% more than the percent on an as fed basis
This product contains ~20% protein DMB
Review of Basic Nutrients:Carbohydrates Energy source
Conditionally essential23% for gestation and lactation in dogs
Cats are different
Provides form to dry and canned food Increases food volume Reduces cost
Benefits of Insoluble Carbohydrates
“Normalize” bowel transit time Increase satiety Provide probiotics for intestinal health
Review of Basic Nutrients - Carbohydrates
Soluble Insoluble “Fiber”
SugarsStarches …etc.
Beet pulpCelluloseSoybean hulls …etc.
Review of Basic Nutrients - Proteins
Tissue Building Growth Hormones Enzymes Blood Cells Antibodies Energy source
Comprised of Amino Acids
Review of Basic Nutrients - Proteins
Essential Amino AcidsArginine PhenylalanineHistidine ThreonineIsoleucine TryptophanLeucine ValineLysine Taurine*
Methionine
Amino Acids of Special ConcernArginine
(Essential)Immune system stimulant; key in management of dogs with cancer
Taurine(Essential in
cats)
Critical for retinal and cardiac muscle development in cats; Conditionally essential in Newfoundlands
Carnitine(Conditionally
essential)
Improves fat metabolism, builds lean body tissue, make mitochondria more efficient
Review of Basic Nutrients:Protein
Plant Protein Sources Animal Protein Sources
More consistent in qualityMore bioavailable
(no cellulose layer to break down)
Needs to be combined with other plants to be complete More complete
More expensive
AAFCOAssociation of American Association of American
Feed Control OfficialsFeed Control Officials
Nutrient Profiles forNutrient Profiles for dogs and cats dogs and cats
minimum nutrient values minimum nutrient values required at different liferequired at different lifestagesstages
some maximumsome maximum values values
Review of Basic Nutrients - Proteins
Adult Dog – 18%Puppy – 22%
Adult Cat – 26%Kitten – 30%
AAFCO PROTEIN minimums - DMB
Review of Basic Nutrients - Fat
Energy source
Critical for the absorption, storage & transport of fat soluble vitamins (A, D, E, K)
Supplies Essential Fatty Acids (EFA)Common sources: Flaxseed, linseed, menhaden fish,
animal fat, evening primrose oil, black currant oil
Contributes to food’s palatability
Review of Basic Nutrients - Fat
Linoleic acid (n-6)
Alpha linolenic acid (n-3)
Arachidonic acid (n-6)
Maintain cell membrane integrity
Help control water loss from skin
Review of Basic Nutrients - Fat
Adult Dog – 5%Puppy – 8%
Adult Cat – 9%Kitten – 9%
AAFCO FAT minimums - DMB
Review of Basic Nutrients – Minerals Minerals of Special Concern in Dogs & Cats
Mineral Mineral Diseases ExacerbatedDiseases ExacerbatedSodium Heart failure
HypertensionKidney disease
Calcium Skeletal disease (pups)Bladder stones
Phosphorus Kidney failureSkeletal diseaseBladder stones
Magnesium Struvite bladder stones
What Determines How Much an Animal Eats?
Energy Needs +
• Palatability • Competition• Reward• Attention• …
Energy Needs
Growth
Reproduction/lactation
Activity level
Breed
Temperament
Environmental conditions
Intact or neutered
Calculating Energy Requirements
RER – Resting Energy Requirement Measure of the amount of energy needed
based on animal’s metabolic body size
Formula:
Expressed in kilocalories
RER = 30 x BW(kg) +70
STEP 1
Calculating Energy Requirements
DER = Daily Energy Requirement An animal’s RER multiplied by a factor that accounts
for the animal’s life stage or life style
DER Factor = Numeric value that accounts for life stage, neuter status, life style, body condition, gestation or lactation
STEP 2
DER = RER x DER factor
Calculating Energy NeedsWhat You Need to Know About the
Animal Before You Calculate:
Age Neuter Status Current Weight Target Weight
(if not at ideal weight)
How Much Will We Feed Gracie Whitesox?
“Gracie Whitesox”3yrs; Female(N) Maine Coon; Wt. 11lbs; BCS 3/5
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
30 x (11 ÷ 2.2) + 70
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
30 x (11 ÷ 2.2) + 70 30 x (5)+70 = 220 kcals
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
30 x (11 ÷ 2.2) + 70 30 x 5+70 = 220 kcal
Calculate DER: Average, neutered feline adult =
(Use DER factors provided in notes)
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
30 x (11 ÷ 2.2) + 70 30 x 5+70 = 220 kcal
Calculate DER: (Use DER factors provided in notes)
Average, neutered feline adult = 1.2 x RER
Calculating Gracie’s Energy Needs Calculate RER: 30 x (BW in kg) +70
30 x (11 ÷ 2.2) + 70 30 x 5+70 = 220 kcal
Calculate DER: (Use DER factors provided in notes)
Average, neutered feline adult = 1.2 x RER 1.2 x 220 = 264 kcals per day
Gracie should have 264 kcals per day
Calculating Gracie’s Energy Needs
Find the food’s metabolizable energy: ex: Purina® Cat Chow® Indoor Formula =
379 kcal per cup
Divide Gracie’s DER by the #kcal per cup/can of food DER = 264 ÷ 379 = ~3/4 cup per day
Gracie should eat ~3/4 cup of cat food per day
Gracie’s DER is 264 kcal per day
How much food should she eat per day?
How Much Should
Breeze Eat?
11-years old M(N)Shetland Sheepdog, 21# BCS 3/5
Source: Geneva Acor
TerminologyLife Stage
AdultAdult GrowthGrowth SeniorSenior Reproduction/Reproduction/
LactationLactation
Life Stage FeedingThe practice of feeding animals foods designed to meet their optimal nutritional needs at a specific age or physiologic state
Feeding an animal above or below their optimal nutritional level can negatively affect their health. “Cowboy” 5 mos.
Nutrition Recommendation
“An animal’s health status must be assessed individually in order to determine the most beneficial course of action.”
What types of life stages and would you consider when making a nutritional
recommendation?
Different Life Stages = Different Nutritional Requirements
Growth, Reproduction & LactationSmall & Medium Breeds vs. Large Breeds
Adult
Senior
Small Animal Clinical NutritionNutrient Profiles Published For
Dogs and Cats
Recommended Nutrient Ranges (OPTIMAL LEVELS)
All Life StagesOn reserve in Library
Life Stage: Adult
Recommended
3500Kcal/kg
AAFCO Minimum
Calories/Energy Fat Calcium PhosphorusProtein
2.5% 1.6%
0.5% 0.6% 5% 18%
.4%-.9%.5%-1.0%10-20%15-30%
3500 - 4500Kcal/kg
Life Stage: Adult – Canine
Image Source: Dr. Geneva Acor, Hill’s Pet Nutrition, Inc.
What Defines a Large Breed Dog?
ANY DOG WHOSE
IDEAL ADULT WEIGHT IS 55# OR
MORE
Life Stage: Large Breed Adult Carnitine
Increases & improves fat metabolism
Supports healthy heart
Glucosamine & Chondroitin Helps maintain healthy joints
Life Stage: Adult - Feline
Recommended
4000Kcal/kg
AAFCO Minimum
Calories/Energy Fat Calcium PhosphorusProtein
0.5% 0.04%9% 26%
0.5%-0.8%0.04-0.1%
10-30%30-45%
4000 - 5000Kcal/kg
Source: Hill’s Pet Nutrition, Inc.
Life Stage: Adult - FelineTaurine
Essential Amino Acid; Helps maintain normal heart function, retinal structure, and reproduction and development
Magnesium Avoid excesses
How Much Food Does Bevo Need?
RERRER = 30 x (BWkg) +70
DER Factor Pg. 15
DER
# cups to be fed/day
“Bevo” 2yrs old;•M(N) 40# BCS 3/5
•Average activity level
•Eats Purina ONE™ Beef & Rice Formula 441 kcals/cup
616 kcals
1.6
1.6 x 616 kcals = 986 kcals
986 kcals per day441 kcals/cup = 2¼ cups
Life Stage: GrowthCarly, 5 months
Amanda Adels
“Maisey” 8 monthsStephanie Caviglia
Life Stage: Puppies & KittensAs Compared with Adult Nutritional Needs
PROTEIN
PHOSPHORUSCALCIUMFATCarbohydrates
Life Stage: Large Breed Puppy
Life Stage: Large Breed PuppyAs Compared with Small/Medium Breed Puppies
PROTEIN
PHOSPHORUSCALCIUMFATCHO
Ben, 8-year old, mixed breed
Pre-surgical radiographPre-surgical radiograph
Ben, 8-year old, mixed breed
Post-surgical radiographPost-surgical radiograph
Ben, 8-year old, mixed breed
What Purina Learned…The Purina Life Span Study
14 year study (1987 – 2001)
Purpose: “Evaluate the effects of food intake on body condition…and life span.”
www.purinavets.comUser name: purinavets
Password: nutritionSearch: Life Span Study
JAVMA, Vol. 220, No. 9, May 1, 2002
Life Span Study Parameters
48 Labrador Retrievers
Paired by sex and weight and assigned at random to control or limit-fed group
Followed for 14 years
Evaluated radiographs for osteoarthritis
Obesity & Skeletal Disease
Control Group
Limit-fed Group
Hip joint lesions 15/22 3/21
Shoulder joint lesions 19/22 12/21
Clinical Findings
JAVMA, Vol. 220, No. 9, May 1, 2002
Clinical Findings
Feeding dogs to a leaner body condition increases their life span and reduces
incidences of osteopathies
Excess Fat/Energy Density
Beware Excessive Calcium in Large Breed Dog Diets
11 Great Dane pups (5 - 10 weeks old)
Fed free choice for 1 hour twice daily
5 fed food with 1.1% Calcium
6 fed food with 3.3% Calcium
JAAHA, 21:377 1985JAAHA, 21:377 1985Excess Calcium
1.18% Ca 3.3% Ca
Excessive Calcium
Hazewinkle, Thesis, Utrecht 1985
Life Stage: Reproduction/Lactation
Baby & PupsBaby & Pups
Life Stage: Canine Reproduction/Lactation
Canine Gestation
First 42 days: Feed as average adult
Last 21 days: Feed 3 x RER
Canine Lactation
Varies with number of puppies Range is from 3 x RER to
≥ 6 x RER Feed ad libitum Energy needs peak at 4 th
week of lactation
Life Stage: Feline Reproduction/Lactation
Thepetcenter.com
Wikipedia.com
Life Stage: Feline Reproduction/Lactation
Feline Gestation
Consumption increases linearly during gestation
Increase to 1.6 x RER at breeding
Feline Lactation
Greatest nutritional need peaks at 6 th week
2 to 6 x RER, ad libitum
FEEDING ANNIE
•“Annie” F(I); 4 yrs old Dalmatian•62# BCS 3/5•Whelped 7 pups 2 wks ago
RERRER = 30 x BWkg +70
DER Factor
DER
# cups to be fed/day
910 kcals
5.5
5.5 x 910 kcals = 5005 kcals
5005 kcals per day372 kcals/cup = 13½ c.
Which Type of Food Will You Feed Annie
While She’s Pregnant And Lactating?
REGULAR PUPPY FOODSD Puppy Lamb Meal and Rice Formula
Life Stage: Senior
“Ginger” 14 yrs, F(N) Scottish Terrier
Stephanie’s Cat 18 yrs, M(N) DSH
Crystal Branch
Stephanie Caviglia
Life Stage: Senior Dogs & CatsAs Compared with Adult Life Stage
PROTEIN
PHOSPHORUSSODIUMFATCHO
Life Stage: Senior
“Minky” 15 years
Glucosamine & Chondroitin• Helps maintain healthy joints
Controlled Sodium• Helps protect heart health
Controlled Phosphorus• Helps protect kidneys in old age
Life Style FeedingFeeding animals foods formulated to support optimal health and meet their nutritional needs based on their life style and activity level.
Life Style Terminology Active Obesity Prone
Life Style: Active Adult
High Energy
Density
What is the most important What is the most important nutritional factor for annutritional factor for an
active lifestyle? active lifestyle?
Life Style: Active CanineAs Compared with Adult Life Stage
PROTEIN
PHOSPHORUSCALCIUMFATCHO
Flickr
Life Style: Obesity & Obese Prone
“Light” or “Lite” or “Low Calorie”
AAFCO Guidelines
Less than 3100 kcal/kg dry dog food
Less than 3250 kcal/kg dry cat food
Life Style: Obesity & Obese ProneAs Compared with Adult Life Stage
PROTEIN
PHOSPHORUSCALCIUMFATFIBER
Source: Funny-cats.com
No visible waistline
Fat pools aroundtailbase
“Missy”English Pointer
F(N); 92# BCS 5/5
Karen Pogmore
“Rocky” 7years, M(N) DSH 20# BCS 5/5(enjoys yoga )
Nicole Polizzi
Managing Obese & Obese Prone Animals
FOOD
FEEDING METHOD
EXERCISE
OWNER
Managing Obese & Obese Prone Animals
Beware of Marketing Claims
FOOD EXERCISE FEEDING METHOD OWNER
Amadeus, 26lbs
FOOD FEEDING METHOD EXERCISE OWNER
Feeding Methods
Ad libitum
Time limited
Portion limited
FOOD FEEDING METHOD EXERCISE OWNER
Exercise is Important Too!
What Are Some Ways To Get Your
Cat to Exercise?
FOOD FEEDING METHOD EXERCISE OWNER
Rocky’s Energy Needs
“Rocky” 7yrs; M(N), DSH20lbs, BCS 5/5
RULE FOR OVERWEIGHT ANIMALS
Calculate RER based on TARGET WEIGHT, NOT Current Weight
WHERE WOULD YOU FIND ROCKY’S
TARGET WEIGHT?
Rocky’s Energy Needs
RERRER = 30 x BW(kg) +70
DER Factor
DER
# cups to be fed/day
315 kcals
0.8
0.8 x 315 kcals = 252 kcals
252 kcals per day283 kcals/cup = ~4/5 cup
INTERIMTarget Weight: 18 lbs
Science Diet® Feline Hairball Control Light
Adult – Dry283 kcals/cup
“Rocky” 7yrs; M(N), DSH20lbs, BCS 5/5
Next Week: Pet Food Labels
BRING A LABEL FROM A CAN, BAG, POUCH,
CHUB, or FOIL PACK OF DOG OR CAT FOOD
ONLY