Content continues after advertisement

Nutrition Assessment in a Dog with Osteoarthritis & Obesity

Maryanne Murphy, DVM, PhD, DACVN, University of Tennessee

Tamberlyn D. Moyers, LVMT, VTS (Nutrition), University of Tennessee

Gregg K. Takashima, DVM, WSAVA Global Nutrition Committee Series Editor

Kara M. Burns, MS, MEd, LVT, VTS (Nutrition), Olathe, Kansas

Nutrition

|January 2018|Peer Reviewed

Sign in to Print/View PDF

THE CASE

An 8-year-old neutered male pug was presented for a weight-loss plan 2 weeks after bilateral cranial cruciate ligament (CCL) repair; the surgeon had suggested the weight-loss plan to aid in healing and long-term health. The owners reported that, before CCL repair, the dog was reluctant to walk, seemed stiff, and spent the majority of most days in a recumbent position.

On presentation, the dog weighed 71.9 lb (32.6 kg), with a BCS of 9 out of 9 and adequate muscle mass. Body fat percentage was estimated at 65% based on palpation and a body fat index chart.1 He was able to walk only a few steps at a time with substantial sling support, which had not been necessary before surgery. The owners had been instructed to maintain crate rest because of the CCL repair until otherwise directed by the surgeon.

CBC, serum chemistry profile, urinalysis, and T4 results were within normal limits. Bilateral stifle radiographs obtained before surgery showed periarticular osteophytes on both patellae and trochlear ridges, bilateral effusion, and bilaterally compressed fat pads.

Dietary History

The dog was reportedly fed once daily in the evening. A typical meal consisted of either 2 hot dogs, half a grilled boneless skinless chicken breast, or a grilled hamburger and one to 2 chocolate chip cookies. He also had access to an adult dry feline maintenance diet, which was always available for the 5 cats living in the home. No commercial dog food was included in his diet. Based on the USDA National Nutrient Database for Standard Reference, the human foods contributed approximately 374 to 566 calories per day.2 The owners were unable to identify the manufacturer of the feline diet or estimate the dog’s daily consumption of this diet, so additional caloric contribution could not be determined.

DIAGNOSIS:

OSTEOARTHRITIS & OBESITY

Treatment

Based on the dog’s weight on presentation and estimated body fat percentage, the dog’s ideal body weight (IBW) was approximately 31.5 lb (14.3 kg).3,4 Using this IBW, his resting energy requirement (RER) was estimated to be 515 kcal/day, and maintenance energy requirement (MER) was 412 kcal/day using a 0.8 life stage factor (see How to Calculate IBW, RER, & MER).5 A life stage factor of 0.8 to 1.0 is recommended for weight loss; the lower factor was chosen in this case due to the patient’s high BCS. These calculations mirrored similar caloric recommendations reported in other weight-loss regimens.6 If a treat allowance is required, reserving 10% MER for this purpose is generally recommended.

How to Calculate IBW, RER, & MER3

  • IBW = [current body weight in kg × (100% – body fat percentage)] ÷ 80%

[32.6 kg × (1.0 – 0.65)] ÷ 0.8 = 14.3 kg

  • RER = 70 × (ideal body weight in kg)0.75

70 × (14.3 kg)0.75 = 515 kcal/day

  • MER = RER × life stage factor

515 kcal/day × 0.8 = 412 kcal/day

Of this patient’s 412-kcal/day MER, 377 kcal/day was allocated to the selected maintenance diet and 35 kcal/day to treats. One and two-thirds cups (375 kcal) per day of a dry therapeutic weight-loss diet formulated to meet the nutrition requirements established by the Association of American Feed Control Officials (AAFCO) Dog Food Nutrient Profiles for maintenance was prescribed. The owners were given a list of various human foods—and their associated caloric content—that could be used for the dog’s 35-kcal/day treat allowance. He was also started on eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) provided via a liquid fish oil product (see Suggested Reading). Each teaspoon contained 690 mg of EPA, 414 mg of DHA, and 41 kcal, which was not factored into the dog’s weight-loss plan due to concerns about owner compliance (see Owner Education). The owners were instructed to remove access to the feline dry food.

Outcome

The dog’s progress was rechecked once weekly for the first month of the weight-loss plan, then every 4 weeks over the next year. Once he was cleared for activity by the surgeon who performed the CCL repair, the owners were instructed to start 5-minute leash walks twice daily, with an eventual increase to 20 minutes twice daily. Daily feeding amounts were periodically adjusted to maintain a weight-loss rate of 1% to 2% of the dog’s current body weight per week. As he lost weight, the owners reported it was easier for him to rise from a sitting position and that he seemed less stiff when walking as compared with before CCL repair. When the dog achieved his ideal weight and BCS, the owners reported return to an apparent normal gait. He no longer had difficulty rising and was able to take 30-minute daily leash walks with at least one 60-minute walk per week.

Owner Education

The owners were feeding an unbalanced diet consisting of human food of low nutritional value. Part of the initial weight-loss consultation included discussing the challenges the owners may have faced when switching the dog from a human-food–based diet to an extruded kibble-based diet. The owners were instructed to introduce the new diet by adding a small portion of the new diet to the evening meal and removing a portion of the human food items. The owners were also instructed to stop feeding chocolate chip cookies. Over approximately 4 to 7 days, the kibble portion was increased while the human food portion was decreased. If they could not make this transition within that time frame, a balanced homemade diet plan could be considered. 

The owners were concerned about continued begging for food. Specific scenarios and suggested responses were discussed. For example, when the dog would beg for food, the owners could initiate an activity (eg, playing with toys, going for a leash walk); however, due to the CCL repair and the osteoarthritis, all activity also had to be based on this dog’s ability and with the approval of the referring surgeon.

Ideally, the calories provided from supplements, including fish oil, are included in a daily treat allowance. In this case, however, the owners felt the recommended treat allowance was too low, and the veterinary team was concerned about plan adherence if fish oil was the only allowed daily treat. Because total caloric intake—including diet, treats, and supplements—was assessed at each weight recheck, treat allowance could be adjusted based on rate of weight loss. This information was used to further educate the owners about the effect excess calories can have on weight-loss success. If fish oil needed to be incorporated as part of the treat allowance, a reasonable alternative would have been to reserve some of the daily portion of the complete and balanced kibble as a treat.

Conclusion

This case illustrates the importance of nutritional management for weight loss and pain management to improve clinical signs associated with osteoarthritis. It also demonstrates the importance of owner education and compliance.

ASK YOURSELF...

4  Questions
Multiple Choice Questions
Score 0/4

Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz

Take this quiz by answering the following multiple choice questions.
1/4  Questions
Score
Score 0/4

What is the recommended EPA and DHA dose for osteoarthritis management in dogs?

Select one of the above choices and click submit.
Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz
2/4  Questions
Score
Score 0/4

What other supplements could be added to manage this patient’s osteoarthritis?

Select one of the above choices and click submit.
Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz
3/4  Questions
Score
Score 0/4

When should a supplement that provides energy be included in the treat allowance?

Select one of the above choices and click submit.
Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz
4/4  Questions
Score
Score 0/4

What is the most important reason to recommend weight loss as part of the treatment plan for this patient?

Select one of the above choices and click submit.
Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz
4/4  Questions
Multiple Choice Questions
Score 0/4

Nutrition Assessment in a Dog with Osteoarthritis & Obesity Quiz

Final score
0 of 4

AAFCO = Association of American Feed Control Officials, CCL = cranial cruciate ligament, DHA = docosahexaenoic acid, EPA = eicosapentaenoic acid, IBW = ideal body weight, MER = maintenance energy requirement, RER = resting energy requirement

Diet in Disease is a series developed by the WSAVA, the Academy of Veterinary Nutrition Technicians, and Clinician’s Brief.

References and Author Information

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.


This article is published as part of the Global Edition of Clinician's Brief. Through partnership with the World Small Animal Veterinary Association, the Global Edition provides educational resources to practitioners around the world.

Podcasts

Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2023 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | DMCA Copyright | Privacy Policy | Acceptable Use Policy