Muscle condition scores (MCS) Many veterinarians also recommend including an MCS in every medical record. Veterinarians can obtain an MCS by palpating the muscles over the back, head, shoulders, and hips (Freeman, 2017). The MCS is used to assess muscle loss, and results are reported as normal or abnormal with mild, moderate , or severe loss. Most owners do not realize that an animal can be overweight yet still have considerable muscle loss. Additionally, the opposite is true; an animal can be thin and still have a healthy muscle mass. For these reasons, Freeman (2017) emphasizes that it is critical to assess both BCS and MCS together to better evaluate the patient’s overall nutritional status and condition. If you are interested, you can watch this video on how Dr. Lisa Freeman evaluates the MCS of a patient: https://www. youtube.com/watch?v=fzEruEe-WRs&feature=youtu.be The human–animal bond is paramount to these conversations. Leverage this bond by emphasizing current or future QOL concerns. Guide the conversation to daily activities, including feeding, walks, play activity, and stair climbing. Are their pets stiff upon waking or hesitant to jump up to their favorite spots? Owners often do not see these as signs of pain, instead seeing them as normal effects of aging. We must help them recognize that age is not a disease. When they understand this, they can appreciate that their pet is in pain, not just getting old. Finally, do not forget about body language during these conversations. When speaking face-to-face with clients, Ward (2017) emphasizes that we should use an open body posture: ● Maintain a 45-degree angle to the owner, with no barriers between you—no papers, tables, or charts ● Do not cross your arms or legs. ● Maintain eye contact. ● Speak in a normal, friendly tone of voice. ● Talk about the pet’s health, not the pet’s weight. Acknowledge the relationship the owner has with the pet, saying something like “Mrs. Y, I know how much you care for X, and that is why I want to discuss his weight.” ● Ask the owner their thoughts on their pet’s weight. ● Review the significant health risks with the owner. ● Take the initiative and start early; be consistent and address weight with your clients at every visit, even if it is something as simple as “I see that X’s weight is unchanged; that is perfect, as I can feel her ribs easily and she has a waist at the end of the ribcage”—praising the maintenance of the body condition tells the owner you appreciate it, and it reminds the owner what is normal.
On a 5-point scale: 1/5 Very thin 2/5 Underweight 3/5 Ideal weight 4/5 Overweight 5/5 Obese
On a 9-point scale:
1/9 Emaciated 2/9 Very thin 3/9 Thin 4-5/9 Ideal 6/9 Overweight
7/9 Heavy 8/9 Obese 9/9 Severely obese
Body condition scores are assigned using visual inspection, with or without palpation.
Talking to clients about obesity and their pet’s risk We have established that BW, BCS, and MCS are critical assessments to identify patients who may be overweight or obese. Additionally, these measurements form a baseline and comparative points for future evaluations. But communicating to owners that their pet may be overweight or obese can be anxiety inducing in many a veterinarian. In a 2017 article, Dr. Ernie Ward discussed ways to improve communication and delivery of the message that obesity is a consequential disease. He recommends the following: ● Avoid offending the owner. ● Avoid misperceptions on our and their part. ● Ask open-ended questions like “Tell me how much you feed your pet throughout the day.” Open- ended questions let the owner tell a story, providing information that is more dependable (and more likely to include people food, licking plates clean, etc.). ● Avoid judgement. Instead of asking, “Do you give treats or table scraps?” say, “Tell me more about Buddy’s favorite human foods or snacks.” The latter is less judgmental, showing you understand the human–animal bond and appreciate that the bond is strengthened through food-sharing. ● Emphasize that obesity is a disease, discussing it in terms of risk factors and consequences. ● Avoid qualifiers such as “fat, chubby, plump, heavy.” State purposefully that the pet is overweight or obese. ● Avoid phrases like “He’s not that fat” and “I’ve seen worse.” Minimizing the disease undermines any future recommendations your team may make. ● Obesity is a complex disease. Show compassion for your clients. By watching your word selection and order, you can improve their acceptance of the diagnosis. This improves the likelihood of gaining active owner participation, acceptance of your recommendations, and adherence to the plan you put in place. Nutritional assessment and guidelines The 2021 American Animal Hospital Association (AAHA) Nutritional and Weight Management Guidelines provide detailed tools and recommendations for managing weight loss and maintaining a healthy weight (Cline et al., 2021). These guidelines discuss various means to achieve weight loss, including caloric restriction, diet selection, and exercise. Veterinarians must partner with clients to overcome a variety of challenges, including comorbidities, diet preferences, and food intolerances.
Banfield Pet Hospital found several factors associated with successful weight loss (Saito, 2020). These included the presence of multiple dogs in the house, consistently measuring feeding amounts, the use of pet care services (such as a dog walker), and pet owner education/ engagement. See Figure 1 for more information. See Figure 2 for key talking points to achieve successful weight loss for your patients.
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Book Code: VFL1526
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