Dr. Paula Ruel

Housetraining dogs and puppies     Managing developmental issues with puppy crating......   http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=738276


Pot for Pain?   Seattle company to market medical marijuana patch to control pain in dogs, cats and horses....   http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=735878


Physical Rehabilitation:  How I transitioned from human to canine patients  A physical therapist shares her story and explores the importance of rehab in practice.....



Practicing Holistic   Dr. Judy Morgan explains "My ultimate goal is to take an animal who is in pain, or is having difficulty walking, and make it more comfortable again... And there is more than one way to get there." ......  http://www.veterinarypracticenews.com/vet-industry-people/profiles-in-medicine/practicing-holistic.aspx


Study: Early Separation from Litter Increases Behavioral Problems  http://www.veterinarypracticenews.com/vet-breaking-news/2011/08/24/study-early-separation-from-litter-increases-chances-of-behavioral-problems.aspx


Head Halter, Medication for Fear Aggression ....   http://www.veterinarypracticenews.com/vet-practice-news-columns/pet-projects/head-halter-medication-for-fear-aggression.aspx


NATURAL STRESS BUSTERS FOR CATS  Stressed cats lead to unhappy humans.... http://www.veterinarypracticenews.com/vet-practice-news-columns/complementary-medicine/natural-stress-busters-for-cats.aspx  




Identifying answers to obesity is the first step to a healthier pet.  In 1995, the largest study to date revealed that about one in three dogs and cats seen by practitioners was overweight or obese.  Twelve years later, we believe that percentage is even greater.  Why do you think we are struggling with obesity in our veterinary patients?
We see more obese pets because we have a society of sedentary owners and sedentary pets.  The concept of what a healthy animal looks like is different than it was 30 years ago.  Our ability to judge an overweight animal has improved tremendously.  Veterinarians are diagnosing obesity more because we now have the proper parameters for scoring body condition. 

To determine if a dog is overweight, we use the nine-point scale, or body condition score (BCS) system - 5 is ideal, greater than 5 is overweight, and less than 5 is underweight.  Most clients choose a lower number than the pet's actual score.  I think an important factor is that owners tend to show their love by offering food or treats.  Food makes their pets happy, which makes them happy, and they continue to offer treats even though the pets are overweight.

As far as risk factors, we break it down to pet factors (age, breed, neuter status, health), owner factors (weight, activity level, work vs. stay-at-home), diet factors (palatability and nutrient density of food), and veterinarian factors (comfort and competence in discussing and managing obesity).  We recommend early spaying and neutering, which affects the metabolic rate and reduces the pet's energy requirement, yet we forget to make a nutrition recommendation, which increases the risk for obesity.

Also, I don't think all clients understand a dog's natural feeding behavior.  Repeatedly, clients say their pets act hungry or beg for more food.  They equate that behavior with their not getting enough nutrition, when it often is just a pet begging for attention.  These are two great opportunities to educate clients.

When clients ask why their dogs always seem to be begging for food, I describe the natural feeding behavior of the dog:  the wild dog is an opportunist and a gluttonous feeder.  If food is there, dogs will almost always consume it because in their wild evolutionary state, they never knew when the next meal would come.

The frequency and type of treats clients give their dogs can increase the risk of obesity or compound an existing obesity condition.  Clients should consider these treat ideas and alternatives to help their obese dog shed pounds and improve overall health:
  •  Keep a container of green beans in the freezer.  If it comes from the hand, the dog will consider it a treat, and it has fewer calories than a cookie.  Popcorn and kibble also are good low-calorie treat alternatives.

  • Cook vegetables in a low-calorie, low-sodium butter substitute or bouillon for an attractive aroma and taste.

  • Break biscuits and treats down and give a piece at a time.  The timing of the treat and positive reinforcement is what's most important to a dog, not the size.

  • Limit treats to 10% of the dog's daily caloric intake:  if a treat is given for going outside, eliminate the cookie the dog gets at the bank's drive-up window.

  • Offer a bowl of dog food from the table:  The dog will still see it as table scraps - and it won't have the fat and cholesterol of steak.

  • Keep a treat diary or daily treat checklist so family members don't give multiple treats.

I think we're learning - 15 years ago a medical record would say, "Healthy but obese".  Until recently, obesity wasn't recognized as a disease.  As educators, we have to convince our clients that obesity is not healthy.

Obesity-associated disease 
This is a great segue into the topic of obesity as a risk factor for disease.  What problems are associated with obesity?  An obvious symptom is the inability to move without pain.  We see a lot of bone and joint problems and osteoarthritis in overweight dogs.

With osteoarthritis comes exercise intolerance.  When owners see the animal having trouble getting around, they think the pet can't go for a walk, which compounds the problem. 

A  lot of canine patients are consults from an orthopedist.  They highly prefer the dogs to be on a weight-loss program or demonstrate weight loss prior to surgery.   Purina's 14-year Life Span study concluded that overweight dogs actually had a shorter life span.  Not only did they live about two years less, they were grayer and moved more slowly.

That study was probably the most dramatic influence in the veterinary field for practitioners because it confirmed facts about nutrition that we always assumed were true.  Keep the dog lean, and it may have a two-year increase in life span or a three-year delay in the onset of osteoarthritis.  Common sense assumptions were finally validated by a scientific study. 

Also in that study, the control dogs had a BCS between 6 and 7 (of 9), vs,. a 4 to 5 in the lean dogs.  This apparently small difference between healthy lean and slightly overweight has a big impact on potential quantity and quality of life.  After pet owners learn about BCS, they need constant reinforcement because peer pressure is so powerful.  When the neighbor is saying, "Your pet is too thin", it hurts because nutrition is a primary way we care for our pets.  Veterinarians need to reinforce our message on every visit. 

Many researches have documented increased inflammatory mediators in obesity.  How can an increase in inflammatory mediators or oxidative stress actually contribute to the diseases linked with obesity?  Traditionally we thought carrying excess weight was just carrying around a lump of lard.  Now data indicate that the effects are not only mechanical, but also hormonal.  People can understand the increased mechanical stress on the joints and the heavier load for the heart.  What they may not know is that the adipose tissue is an incredibly active organ creating and releasing hormones as well as inflammatory mediators, such as cytokines or adipokines.  Obesity is like having chronic low-level inflammation, which may contribute to many of the chronic diseases we see in overweight or obese dogs.

I think people generally understand weight-related problems.  Overweight clients will say they feel better when they lose 5 to 10 lbs.  We try to emphasize BCS rather than pounds.  If you have a 7-lb. Yorkie that should weigh 6 lbs., 1 lb. of weight loss may not sound like much.  But if they go from a BCS of 7 to 5, that's a big improvement.  So the focus shifts from pounds to BCS. 

Educating Clients about Obesity 
When I explain the dangers of obesity to clients, I don't get extremely technical.  We talk about the inflammatory responses of adipose tissue, and I normally explain that an overweight or obese pet may not feel as well, won't heal as quickly, and will be more prone to develop other diseases like respiratory and cardiac disease and diabetes.  Those are words clients can recognize, relate to, and fear.

When the overweight pet has an overweight owner, this can be a touchy subject.  Sometimes I start with humor and try to establish a rapport, but then you have to address the seriousness of the situation.  The problem is within owners' control.  The dog does not open the refrigerator door.  The owner controls what the pet consumes and has the ability to help the pet lead a healthier life.  

I'm a big believer in assessing the client's readiness for change.  Through questioning, we can glean a lot about what the pet eats, about the owner's lifestyle, and their bond with their pet.  I tell them I am partnering with them and offer them a number of strategies they can pick from.  I also give clients permission to fail. We know we might slip or stumble, but that's okay because it takes many small steps to achieve success.

To get clients more involved in the weight-loss process, make it fun and measurable for them.  Facilitate group exercise for clients and patients.  Meeting at a local park regularly for a walk can be enjoyable for clients and pets.  Start out with a short walk, then gradually increase the distance.  Give them a reference point.  Take before and after pictures so that they can see measurable results.  Weight gain and weight loss can be subtle, making it difficult for clients to know if a diet is working. 

During a pet's annual exam, we say, "I see Fluffy has gained 5 lbs. this year, so let's look at her BCS. Where do you think fluffy is on our chart?"  That opens the door to discussing obesity.  Clients have to admit that there is a problem, and a picture is worth a thousand words.  The obesity chart comes in handy for us and clearly illustrates the comparison between pets of acceptable body condition and those that are overweight.

It's important to establish a relationship with your veterinarian to achieve optimal weight. 

Source Info:  Publication (VET 1595A-0907) - Nestle Purina
               Title:  Canine Obesity 2007
Moderator:   Dottie Laflamme, DVM, PhD, DACVN
                    Senior Research Scientist @ Nestle Purina
                    Heather Prendergast, RVT
                    Practice Manager @ Jornada Veterinary Clinic
                    Lynn Buzhardt, DVM
                    Co-Owner, The Animal Center
                    Rebecca Remillard, PhD, DVM, DACVN
                    Veterinary Nutritionist @ MSPCA Angell Animal Medical Center
                    Julie Churchill, DVM, PhD
                    Asst. Clinical Professor, Companion Animal Nutrition, University of Minnesota