Loss of articular cartilage in both dogs and people has been well documented due to excess body fat and the long-term stress placed on joints with obesity (Johnson Monitoring and maintenance Follow-up is critical. Waiting until the next annual visit to check in with the owner and recheck BW would be a big mistake. We need short, simple, easily attainable goals and regular check-ins to evaluate how the plan is working, evaluate how the owner and the pet are doing, and modify the program as needed. We must ensure that the pets are eating the food, not begging, and are not demonstrating anxiety or destructive or aggressive behaviors because of the changes in food intake. Brooks and colleagues (2014) recommend either a weight check or a telephone call (or text or email) every one to two weeks to ask how they are doing and find out what concerns and questions they may have. Remember, checking in with the owner is not a substitute for physically seeing the pet. Every month, the pet should have a weight check with a trained practice employee. We want to ensure that they are losing weight, not losing muscle mass, and reevaluate the BCS and MCS. We want to closely monitor the rate of weight loss to ensure that they are not losing too slowly or too quickly. Acceptable weight loss in dogs is 1% to 2 % per week, and in cats an acceptable rate of loss is 0.5% to 2% per week (Brooks et al., 2014). If the pet is still growing, additional modifications will be needed. Note that those with comorbidities often lose weight at slower rates. Do not forget to monitor the MCS. If it is decreasing, reevaluate the overall diet and ensure adequate protein intake or check for a catabolic condition. You may need to adjust the rate of loss or reevaluate caloric intake as well as assess other nutrients (Brooks et al., 2014). By setting attainable and straightforward goals for the owner and the pet, you maintain the owner's interest and compliance. The best way to ensure goals are easily attainable for all parties involved is by creating SMART goals. These goals should be Specific, Measurable, Achievable, Relevant, and Time-bound” (Mind Tools, n.d.). So, what does this mean? If we make simple goals, such as feed X amount, start exercising X amount, we can measure success, weight loss, BCS changes, and increased pet energy. We agree upon an attainable goal, such as 1% to 2% weight loss for the first month, and the goals are relevant to the individual patient. They are realistic and relevant expectations, customized for our patient. Finally, we set a time limit, one month, before moving to another target. SMART goals set our clients and patients up for success! The successful client and pet will want to continue and keep coming back. They are going to be encouraged and feel good about their efforts. Then you can set up that next SMART goal and set up the recheck evaluation for a month later. But:
et al., 2020; Messier, 2008; Sanderson, 2012). While obesity is not the only cause of arthritis, it is a factor. By removing this factor from the equation, we can seek to improve the QOL of our patients. ● If weight loss is more than the acceptable weight loss rates, “increase calories by 10% and monitor response” (Brooks et al., 2014). ● If weight loss does not occur or is not enough, then what? We all know that not everyone will be successful every time. To determine why, we need to evaluate several things (Brooks et al., 2014): ○ Influencing factors, including how strictly the owners are adhering to the prescribed plan. Other factors that may play a role, such as bad weather and decreased exercise. ○ If the evidence shows owner and patient compliance, try reducing the calories another 10% to 20%. Alternatively, change activity recommendations or suggest a combination of the two. Then set the next goal. Brooks and colleagues (2014) feel patients can “tolerate caloric restriction as low as 60% of the RER of ideal BW without adverse clinical signs.” However, further restriction, especially in cats (which have a risk of hepatic lipidosis), is not recommended. A change in diet or consultation with a board-certified nutritionist is recommended if weight loss is still not being achieved. Goal attained Weight maintenance can be a problem. Many pets will regain the weight they lost. We must ensure our nutritional counseling and monitoring of the pet’s BW, BCS, and MCS do not falter. We must evaluate all three at every visit. As visits become less frequent, we must have a team member put their eye on the pet and get those measurements every few months. Consider offering a half-price nail trim or other services to help to encourage owners to comply with recommendations, especially for those pets who do not travel well. Once they achieve IBW, we need to decide on the maintenance diet and quantity. This amount will be based upon the pet’s overall metabolic needs, which we may not yet know. Some pets may develop a lower resting metabolic rate because of caloric restriction, while some may also continue losing weight once the IBW is reached. Thus, the first step would be to increase kcal by 10%, adjusting from a weight loss to management level, but continue to monitor BW, MCS, and BW biweekly until they continue to maintain a steady weight without a further loss (Brooks et al., 2014). Keep in mind that while caloric restriction is the mainstay of treatment to date in small animals, additional diet modifications may include (Shmalberg, 2013): ● Increased protein intake ● Lower carbohydrate and fat intake ● Added fiber (to increase satiety) ● High-moisture-content food ● Added ingredients such as L-carnitine, fish oils, and antioxidants
Prevention Excess body fat leads to an inflammatory cascade, which can lead to chronic inflammation, arthritis, and many other conditions. Therefore, the prevention of obesity is fundamental to preventive care. We must practice
prevention from the beginning and reinforce with each visit the importance of weight management and the ideal body condition for each pet.
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