Quiz: What Should I Feed This Cat?

The correct answer is D.

Client compliance and follow-up are the most important aspects of a successful weight loss program. Ruling out problems not directly related to the therapeutic diet (eg, client offering treats to cat, cat having access to human or other pets’ food) may eliminate the need to switch the diet (switching the diet without addressing core problems can be counterproductive). If key information related to compliance is not recorded in the dietary history, simply decreasing the quantity of therapeutic diet consumed may not resolve the weight loss issue and may place the patient at higher risk for nutrient deficiencies; in addition, drastic caloric reduction (30%) may increase the risk for weight rebound¹ and waiting 2 months before rechecking the cat’s health status may worsen the situation. Regarding carnitine supplementation, more studies that define dose and efficacy are needed before clinicians should recommend supplementation.² 

Unless clients are specifically asked, they often fail to include treats as part of the pet’s diet or to mention potential access to other pets’ food, which is why it is important to pursue dietary history if initial weight loss is unsuccessful. In addition, there is evidence of considerable inaccuracy in how clients measure the pet’s food,³ so clients should be asked whether they are using a standard 8-oz measuring cup or a kitchen scale. Other compliance issues may involve different family members being responsible for feeding, family members not agreeing with the weight loss plan, or a new pet sitter being unaware of the diet plan. If compliance and the dietary history are confirmed, then reducing the total caloric intake (food and treat allowance) by 10% and then reweighing in 1 to 2 weeks is the next best step.⁴ In this particular case, the client reported that Maddie had been jumping onto the kitchen counter to access another cat’s higher-calorie food. 

The correct answer is D.

Client compliance and follow-up are the most important aspects of a successful weight loss program. Ruling out problems not directly related to the therapeutic diet (eg, client offering treats to cat, cat having access to human or other pets’ food) may eliminate the need to switch the diet (switching the diet without addressing core problems can be counterproductive). If key information related to compliance is not recorded in the dietary history, simply decreasing the quantity of therapeutic diet consumed may not resolve the weight loss issue and may place the patient at higher risk for nutrient deficiencies; in addition, drastic caloric reduction (30%) may increase the risk for weight rebound¹ and waiting 2 months before rechecking the cat’s health status may worsen the situation. Regarding carnitine supplementation, more studies that define dose and efficacy are needed before clinicians should recommend supplementation.² 

Unless clients are specifically asked, they often fail to include treats as part of the pet’s diet or to mention potential access to other pets’ food, which is why it is important to pursue dietary history if initial weight loss is unsuccessful. In addition, there is evidence of considerable inaccuracy in how clients measure the pet’s food,³ so clients should be asked whether they are using a standard 8-oz measuring cup or a kitchen scale. Other compliance issues may involve different family members being responsible for feeding, family members not agreeing with the weight loss plan, or a new pet sitter being unaware of the diet plan. If compliance and the dietary history are confirmed, then reducing the total caloric intake (food and treat allowance) by 10% and then reweighing in 1 to 2 weeks is the next best step.⁴ In this particular case, the client reported that Maddie had been jumping onto the kitchen counter to access another cat’s higher-calorie food. 

The correct answer is D.

Client compliance and follow-up are the most important aspects of a successful weight loss program. Ruling out problems not directly related to the therapeutic diet (eg, client offering treats to cat, cat having access to human or other pets’ food) may eliminate the need to switch the diet (switching the diet without addressing core problems can be counterproductive). If key information related to compliance is not recorded in the dietary history, simply decreasing the quantity of therapeutic diet consumed may not resolve the weight loss issue and may place the patient at higher risk for nutrient deficiencies; in addition, drastic caloric reduction (30%) may increase the risk for weight rebound¹ and waiting 2 months before rechecking the cat’s health status may worsen the situation. Regarding carnitine supplementation, more studies that define dose and efficacy are needed before clinicians should recommend supplementation.² 

Unless clients are specifically asked, they often fail to include treats as part of the pet’s diet or to mention potential access to other pets’ food, which is why it is important to pursue dietary history if initial weight loss is unsuccessful. In addition, there is evidence of considerable inaccuracy in how clients measure the pet’s food,³ so clients should be asked whether they are using a standard 8-oz measuring cup or a kitchen scale. Other compliance issues may involve different family members being responsible for feeding, family members not agreeing with the weight loss plan, or a new pet sitter being unaware of the diet plan. If compliance and the dietary history are confirmed, then reducing the total caloric intake (food and treat allowance) by 10% and then reweighing in 1 to 2 weeks is the next best step.⁴ In this particular case, the client reported that Maddie had been jumping onto the kitchen counter to access another cat’s higher-calorie food. 

Client compliance and follow-up are the most important aspects of a successful weight loss program. Ruling out problems not directly related to the therapeutic diet (eg, client offering treats to cat, cat having access to human or other pets’ food) may eliminate the need to switch the diet (switching the diet without addressing core problems can be counterproductive). If key information related to compliance is not recorded in the dietary history, simply decreasing the quantity of therapeutic diet consumed may not resolve the weight loss issue and may place the patient at higher risk for nutrient deficiencies; in addition, drastic caloric reduction (30%) may increase the risk for weight rebound¹ and waiting 2 months before rechecking the cat’s health status may worsen the situation. Regarding carnitine supplementation, more studies that define dose and efficacy are needed before clinicians should recommend supplementation.² 

Unless clients are specifically asked, they often fail to include treats as part of the pet’s diet or to mention potential access to other pets’ food, which is why it is important to pursue dietary history if initial weight loss is unsuccessful. In addition, there is evidence of considerable inaccuracy in how clients measure the pet’s food,³ so clients should be asked whether they are using a standard 8-oz measuring cup or a kitchen scale. Other compliance issues may involve different family members being responsible for feeding, family members not agreeing with the weight loss plan, or a new pet sitter being unaware of the diet plan. If compliance and the dietary history are confirmed, then reducing the total caloric intake (food and treat allowance) by 10% and then reweighing in 1 to 2 weeks is the next best step.⁴ In this particular case, the client reported that Maddie had been jumping onto the kitchen counter to access another cat’s higher-calorie food. 

The correct answer is C.

Consistency, adequate protein, and reduced carbohydrates have been shown to be the most effective dietary approach to achieving remission in cats with diabetes.⁵ Although cats with any type of disease may have appetite changes, consistency is important when regulating diabetes, so rotating therapeutic diets is not appropriate. Furthermore, if foods vary in protein, carbohydrate, or calorie content, switching diets may alter insulin requirements and put the cat at risk for hypo- or hyperglycemia. Likewise, changing the current food to a kitten formulation is inadvisable. Many canned kitten foods have high-protein requirements to accommodate rapid growth, and although many canned kitten food options have lower carbohydrate content, they are not formulated to provide consistency in nutrient profiles as compared with veterinary therapeutic diets, and have higher calcium and phosphorus contents⁶ to meet growth requirements as compared with adult diets. While home-cooked recipes can be formulated to be extremely low in carbohydrates, it is difficult for clients to maintain the same level of consistency with each prepared batch, thereby failing to provide a complete, balanced recipe as compared to the content consistency in therapeutic diets. In addition, recipe “drift” and nutritional inadequacy, along with potential bacterial contamination, make raw diets a poor choice.⁷ If clients prefer home-cooking, it is recommended that they use a recipe formulated by a board-certified veterinary nutritionist (www.acvn.org). 

The ideal diet for this cat would be higher-protein, lower-carbohydrate, and moderate-calorie content⁵ (to help offset the cat’s 7/9 body condition score). Many canned diets are available, but low-carbohydrate dry foods have 400 to 600 calories per cup, which could contribute to weight gain as well as worsen existing diabetes.

The correct answer is C.

Consistency, adequate protein, and reduced carbohydrates have been shown to be the most effective dietary approach to achieving remission in cats with diabetes.⁵ Although cats with any type of disease may have appetite changes, consistency is important when regulating diabetes, so rotating therapeutic diets is not appropriate. Furthermore, if foods vary in protein, carbohydrate, or calorie content, switching diets may alter insulin requirements and put the cat at risk for hypo- or hyperglycemia. Likewise, changing the current food to a kitten formulation is inadvisable. Many canned kitten foods have high-protein requirements to accommodate rapid growth, and although many canned kitten food options have lower carbohydrate content, they are not formulated to provide consistency in nutrient profiles as compared with veterinary therapeutic diets, and have higher calcium and phosphorus contents⁶ to meet growth requirements as compared with adult diets. While home-cooked recipes can be formulated to be extremely low in carbohydrates, it is difficult for clients to maintain the same level of consistency with each prepared batch, thereby failing to provide a complete, balanced recipe as compared to the content consistency in therapeutic diets. In addition, recipe “drift” and nutritional inadequacy, along with potential bacterial contamination, make raw diets a poor choice.⁷ If clients prefer home-cooking, it is recommended that they use a recipe formulated by a board-certified veterinary nutritionist (www.acvn.org). 

The ideal diet for this cat would be higher-protein, lower-carbohydrate, and moderate-calorie content⁵ (to help offset the cat’s 7/9 body condition score). Many canned diets are available, but low-carbohydrate dry foods have 400 to 600 calories per cup, which could contribute to weight gain as well as worsen existing diabetes.

Consistency, adequate protein, and reduced carbohydrates have been shown to be the most effective dietary approach to achieving remission in cats with diabetes.⁵ Although cats with any type of disease may have appetite changes, consistency is important when regulating diabetes, so rotating therapeutic diets is not appropriate. Furthermore, if foods vary in protein, carbohydrate, or calorie content, switching diets may alter insulin requirements and put the cat at risk for hypo- or hyperglycemia. Likewise, changing the current food to a kitten formulation is inadvisable. Many canned kitten foods have high-protein requirements to accommodate rapid growth, and although many canned kitten food options have lower carbohydrate content, they are not formulated to provide consistency in nutrient profiles as compared with veterinary therapeutic diets, and have higher calcium and phosphorus contents⁶ to meet growth requirements as compared with adult diets. While home-cooked recipes can be formulated to be extremely low in carbohydrates, it is difficult for clients to maintain the same level of consistency with each prepared batch, thereby failing to provide a complete, balanced recipe as compared to the content consistency in therapeutic diets. In addition, recipe “drift” and nutritional inadequacy, along with potential bacterial contamination, make raw diets a poor choice.⁷ If clients prefer home-cooking, it is recommended that they use a recipe formulated by a board-certified veterinary nutritionist (www.acvn.org). 

The ideal diet for this cat would be higher-protein, lower-carbohydrate, and moderate-calorie content⁵ (to help offset the cat’s 7/9 body condition score). Many canned diets are available, but low-carbohydrate dry foods have 400 to 600 calories per cup, which could contribute to weight gain as well as worsen existing diabetes.

The correct answer is C.

Consistency, adequate protein, and reduced carbohydrates have been shown to be the most effective dietary approach to achieving remission in cats with diabetes.⁵ Although cats with any type of disease may have appetite changes, consistency is important when regulating diabetes, so rotating therapeutic diets is not appropriate. Furthermore, if foods vary in protein, carbohydrate, or calorie content, switching diets may alter insulin requirements and put the cat at risk for hypo- or hyperglycemia. Likewise, changing the current food to a kitten formulation is inadvisable. Many canned kitten foods have high-protein requirements to accommodate rapid growth, and although many canned kitten food options have lower carbohydrate content, they are not formulated to provide consistency in nutrient profiles as compared with veterinary therapeutic diets, and have higher calcium and phosphorus contents⁶ to meet growth requirements as compared with adult diets. While home-cooked recipes can be formulated to be extremely low in carbohydrates, it is difficult for clients to maintain the same level of consistency with each prepared batch, thereby failing to provide a complete, balanced recipe as compared to the content consistency in therapeutic diets. In addition, recipe “drift” and nutritional inadequacy, along with potential bacterial contamination, make raw diets a poor choice.⁷ If clients prefer home-cooking, it is recommended that they use a recipe formulated by a board-certified veterinary nutritionist (www.acvn.org). 

The ideal diet for this cat would be higher-protein, lower-carbohydrate, and moderate-calorie content⁵ (to help offset the cat’s 7/9 body condition score). Many canned diets are available, but low-carbohydrate dry foods have 400 to 600 calories per cup, which could contribute to weight gain as well as worsen existing diabetes.

Some patients with feline lower urinary tract disease can be managed solely by having increased moisture in the diet, but this approach may not be the answer for this cat. Radiography is recommended to determine whether the cat has urolithiasis in addition to crystalluria. If so, dissolution of struvite stones should be considered as well as prevention, with an acidifying diet and moisture content as part of the nutritional plan⁸; thus, feeding any canned diet is not appropriate. Because of the cat’s heart murmur, a high-sodium diet should not be recommended; based on clinical experience, some therapeutic diets for lower urinary tract disease have elevated levels of sodium to encourage increased water intake, but not all of them do. 

In many cases, a therapeutic diet is the best or only choice for disease management, but some cats can be managed with over-the-counter diets that have the same nutritional profile and properties as the therapeutic diets. In this case, there are appropriate over-the-counter diets that are acidifying to reduce risk for struvite formation, along with being high in moisture content. Supplementary management (ie, additional water at each meal, reducing environmental stress, appropriate over-the-counter diet) may be enough for some cats, thereby removing costs associated with therapeutic diets from the decision-making process.⁹

The correct answer is A.

Some patients with feline lower urinary tract disease can be managed solely by having increased moisture in the diet, but this approach may not be the answer for this cat. Radiography is recommended to determine whether the cat has urolithiasis in addition to crystalluria. If so, dissolution of struvite stones should be considered as well as prevention, with an acidifying diet and moisture content as part of the nutritional plan⁸; thus, feeding any canned diet is not appropriate. Because of the cat’s heart murmur, a high-sodium diet should not be recommended; based on clinical experience, some therapeutic diets for lower urinary tract disease have elevated levels of sodium to encourage increased water intake, but not all of them do. 

In many cases, a therapeutic diet is the best or only choice for disease management, but some cats can be managed with over-the-counter diets that have the same nutritional profile and properties as the therapeutic diets. In this case, there are appropriate over-the-counter diets that are acidifying to reduce risk for struvite formation, along with being high in moisture content. Supplementary management (ie, additional water at each meal, reducing environmental stress, appropriate over-the-counter diet) may be enough for some cats, thereby removing costs associated with therapeutic diets from the decision-making process.⁹

The correct answer is A.

Some patients with feline lower urinary tract disease can be managed solely by having increased moisture in the diet, but this approach may not be the answer for this cat. Radiography is recommended to determine whether the cat has urolithiasis in addition to crystalluria. If so, dissolution of struvite stones should be considered as well as prevention, with an acidifying diet and moisture content as part of the nutritional plan⁸; thus, feeding any canned diet is not appropriate. Because of the cat’s heart murmur, a high-sodium diet should not be recommended; based on clinical experience, some therapeutic diets for lower urinary tract disease have elevated levels of sodium to encourage increased water intake, but not all of them do. 

In many cases, a therapeutic diet is the best or only choice for disease management, but some cats can be managed with over-the-counter diets that have the same nutritional profile and properties as the therapeutic diets. In this case, there are appropriate over-the-counter diets that are acidifying to reduce risk for struvite formation, along with being high in moisture content. Supplementary management (ie, additional water at each meal, reducing environmental stress, appropriate over-the-counter diet) may be enough for some cats, thereby removing costs associated with therapeutic diets from the decision-making process.⁹

The correct answer is A.

Some patients with feline lower urinary tract disease can be managed solely by having increased moisture in the diet, but this approach may not be the answer for this cat. Radiography is recommended to determine whether the cat has urolithiasis in addition to crystalluria. If so, dissolution of struvite stones should be considered as well as prevention, with an acidifying diet and moisture content as part of the nutritional plan⁸; thus, feeding any canned diet is not appropriate. Because of the cat’s heart murmur, a high-sodium diet should not be recommended; based on clinical experience, some therapeutic diets for lower urinary tract disease have elevated levels of sodium to encourage increased water intake, but not all of them do. 

In many cases, a therapeutic diet is the best or only choice for disease management, but some cats can be managed with over-the-counter diets that have the same nutritional profile and properties as the therapeutic diets. In this case, there are appropriate over-the-counter diets that are acidifying to reduce risk for struvite formation, along with being high in moisture content. Supplementary management (ie, additional water at each meal, reducing environmental stress, appropriate over-the-counter diet) may be enough for some cats, thereby removing costs associated with therapeutic diets from the decision-making process.⁹

The correct answer is B.

The American Association of Feed Control Officials (AAFCO) does not require testing of dental diets or products; however, the AAFCO stipulates that companies can only claim that their products promote dental health by mechanical (physical abrasive) methods and does not “find these claims objectionable.”¹⁰ Thus, without showing any evidence, a product can claim dental health benefits as long as it is mechanical (eg, dry kibble). Fortunately, the Veterinary Oral Health Council (VOHC), a voluntary organization, offers a product seal of acceptance to companies that provide evidence of safety and efficacy for products that reduce accumulation of plague and calculus (for a list of products with the VOHC seal, visit www.vohc.org. Companies are not required to have therapeutic diets tested, but many have voluntarily elected to apply for VOHC acceptance. Of note, studies have shown only minimal benefit for dry foods versus canned foods,¹¹ and tooth brushing is by far the most important factor in maintaining dental health.¹²

The American Association of Feed Control Officials (AAFCO) does not require testing of dental diets or products; however, the AAFCO stipulates that companies can only claim that their products promote dental health by mechanical (physical abrasive) methods and does not “find these claims objectionable.”¹⁰ Thus, without showing any evidence, a product can claim dental health benefits as long as it is mechanical (eg, dry kibble). Fortunately, the Veterinary Oral Health Council (VOHC), a voluntary organization, offers a product seal of acceptance to companies that provide evidence of safety and efficacy for products that reduce accumulation of plague and calculus (for a list of products with the VOHC seal, visit www.vohc.org. Companies are not required to have therapeutic diets tested, but many have voluntarily elected to apply for VOHC acceptance. Of note, studies have shown only minimal benefit for dry foods versus canned foods,¹¹ and tooth brushing is by far the most important factor in maintaining dental health.¹²

The correct answer is B.

The American Association of Feed Control Officials (AAFCO) does not require testing of dental diets or products; however, the AAFCO stipulates that companies can only claim that their products promote dental health by mechanical (physical abrasive) methods and does not “find these claims objectionable.”¹⁰ Thus, without showing any evidence, a product can claim dental health benefits as long as it is mechanical (eg, dry kibble). Fortunately, the Veterinary Oral Health Council (VOHC), a voluntary organization, offers a product seal of acceptance to companies that provide evidence of safety and efficacy for products that reduce accumulation of plague and calculus (for a list of products with the VOHC seal, visit www.vohc.org. Companies are not required to have therapeutic diets tested, but many have voluntarily elected to apply for VOHC acceptance. Of note, studies have shown only minimal benefit for dry foods versus canned foods,¹¹ and tooth brushing is by far the most important factor in maintaining dental health.¹²

The correct answer is B.

The American Association of Feed Control Officials (AAFCO) does not require testing of dental diets or products; however, the AAFCO stipulates that companies can only claim that their products promote dental health by mechanical (physical abrasive) methods and does not “find these claims objectionable.”¹⁰ Thus, without showing any evidence, a product can claim dental health benefits as long as it is mechanical (eg, dry kibble). Fortunately, the Veterinary Oral Health Council (VOHC), a voluntary organization, offers a product seal of acceptance to companies that provide evidence of safety and efficacy for products that reduce accumulation of plague and calculus (for a list of products with the VOHC seal, visit www.vohc.org. Companies are not required to have therapeutic diets tested, but many have voluntarily elected to apply for VOHC acceptance. Of note, studies have shown only minimal benefit for dry foods versus canned foods,¹¹ and tooth brushing is by far the most important factor in maintaining dental health.¹²

The correct answer is B.

In purebred cats, genetic diseases can be a concern, but no studies have shown that low- phosphorus or low-protein diets can prevent chronic kidney disease (CKD). Regardless of the diet chosen, both cats should be monitored more frequently and their health maintenance plan adjusted accordingly. Renal insufficiency is not considered severe or end stage to the point that Bandit requires severe protein restriction (which, based on clinical experience, could be harmful and cause muscle loss if restricted too early in the disease process). However, studies have shown that limiting phosphorus intake can be associated with slowing progression of CKD,¹³ making this an important factor in nutritional management. In early stages, only mild reduction in phosphorus may be necessary, but frequent rechecking of renal parameters is recommended and additional restriction may eventually be required. 

Many therapeutic diets formulated for CKD have phosphorus and protein restriction below the AAFCO levels required for healthy cats; however, some over-the-counter diets have adequate protein and moderate (<200 mg/100 kcal) phosphorus, making them kidney-friendly and possibly appropriate for both a cat in early-stage CKD and its healthy littermate.

In purebred cats, genetic diseases can be a concern, but no studies have shown that low- phosphorus or low-protein diets can prevent chronic kidney disease (CKD). Regardless of the diet chosen, both cats should be monitored more frequently and their health maintenance plan adjusted accordingly. Renal insufficiency is not considered severe or end stage to the point that Bandit requires severe protein restriction (which, based on clinical experience, could be harmful and cause muscle loss if restricted too early in the disease process). However, studies have shown that limiting phosphorus intake can be associated with slowing progression of CKD,¹³ making this an important factor in nutritional management. In early stages, only mild reduction in phosphorus may be necessary, but frequent rechecking of renal parameters is recommended and additional restriction may eventually be required. 

Many therapeutic diets formulated for CKD have phosphorus and protein restriction below the AAFCO levels required for healthy cats; however, some over-the-counter diets have adequate protein and moderate (<200 mg/100 kcal) phosphorus, making them kidney-friendly and possibly appropriate for both a cat in early-stage CKD and its healthy littermate.

The correct answer is B.

In purebred cats, genetic diseases can be a concern, but no studies have shown that low- phosphorus or low-protein diets can prevent chronic kidney disease (CKD). Regardless of the diet chosen, both cats should be monitored more frequently and their health maintenance plan adjusted accordingly. Renal insufficiency is not considered severe or end stage to the point that Bandit requires severe protein restriction (which, based on clinical experience, could be harmful and cause muscle loss if restricted too early in the disease process). However, studies have shown that limiting phosphorus intake can be associated with slowing progression of CKD,¹³ making this an important factor in nutritional management. In early stages, only mild reduction in phosphorus may be necessary, but frequent rechecking of renal parameters is recommended and additional restriction may eventually be required. 

Many therapeutic diets formulated for CKD have phosphorus and protein restriction below the AAFCO levels required for healthy cats; however, some over-the-counter diets have adequate protein and moderate (<200 mg/100 kcal) phosphorus, making them kidney-friendly and possibly appropriate for both a cat in early-stage CKD and its healthy littermate.

The correct answer is B.

In purebred cats, genetic diseases can be a concern, but no studies have shown that low- phosphorus or low-protein diets can prevent chronic kidney disease (CKD). Regardless of the diet chosen, both cats should be monitored more frequently and their health maintenance plan adjusted accordingly. Renal insufficiency is not considered severe or end stage to the point that Bandit requires severe protein restriction (which, based on clinical experience, could be harmful and cause muscle loss if restricted too early in the disease process). However, studies have shown that limiting phosphorus intake can be associated with slowing progression of CKD,¹³ making this an important factor in nutritional management. In early stages, only mild reduction in phosphorus may be necessary, but frequent rechecking of renal parameters is recommended and additional restriction may eventually be required. 

Many therapeutic diets formulated for CKD have phosphorus and protein restriction below the AAFCO levels required for healthy cats; however, some over-the-counter diets have adequate protein and moderate (<200 mg/100 kcal) phosphorus, making them kidney-friendly and possibly appropriate for both a cat in early-stage CKD and its healthy littermate.

An overweight cat with a prolonged history of anorexia is at increased risk for hepatic lipidosis. Given that the cat was previously healthy and now has muscle wasting is a clinical sign that immediate intervention is required rather than initiating a trial dose or attributing presenting signs with environmental stressors. Appetite stimulants tend to work only short-term and, based on clinical experience, may create a false sense of security if clients are not calculating exactly how many calories the pet is consuming to meet the resting energy requirement (RER). If the cat is stressed or nauseous, forced feeding or coax feeding may cause food aversion, so placement of a feeding tube is indicated in this case. Nasogastric tubes are not recommended for long-term needs or for use outside a hospital setting¹⁴, as cats can remove them. Also of note, because only a liquid diet can be used with nasogastric tubes, they are less versatile for nutrition options. 

Current recommendations are to initiate calorie intake at 10% to 25% of the RER and gradually increase the RER percentage to 100% over 5 to 7 days.¹⁵ In severely malnourished patients, feeding too quickly could increase the risk for refeeding syndrome. Additionally, illness factors, which were previously recommended to provide additional calories for pets that are ill, are no longer recommended for hospitalized patients.¹⁴ Finally, fat content has not been shown to be a factor for hepatic lipidosis, but based on clinical experience, cats and owners are more compliant with the smallest volume possible, which is usually met by a high-fat, high-calorie critical care diet.

The correct answer is A.

An overweight cat with a prolonged history of anorexia is at increased risk for hepatic lipidosis. Given that the cat was previously healthy and now has muscle wasting is a clinical sign that immediate intervention is required rather than initiating a trial dose or attributing presenting signs with environmental stressors. Appetite stimulants tend to work only short-term and, based on clinical experience, may create a false sense of security if clients are not calculating exactly how many calories the pet is consuming to meet the resting energy requirement (RER). If the cat is stressed or nauseous, forced feeding or coax feeding may cause food aversion, so placement of a feeding tube is indicated in this case. Nasogastric tubes are not recommended for long-term needs or for use outside a hospital setting¹⁴, as cats can remove them. Also of note, because only a liquid diet can be used with nasogastric tubes, they are less versatile for nutrition options. 

Current recommendations are to initiate calorie intake at 10% to 25% of the RER and gradually increase the RER percentage to 100% over 5 to 7 days.¹⁵ In severely malnourished patients, feeding too quickly could increase the risk for refeeding syndrome. Additionally, illness factors, which were previously recommended to provide additional calories for pets that are ill, are no longer recommended for hospitalized patients.¹⁴ Finally, fat content has not been shown to be a factor for hepatic lipidosis, but based on clinical experience, cats and owners are more compliant with the smallest volume possible, which is usually met by a high-fat, high-calorie critical care diet.

The correct answer is A.

An overweight cat with a prolonged history of anorexia is at increased risk for hepatic lipidosis. Given that the cat was previously healthy and now has muscle wasting is a clinical sign that immediate intervention is required rather than initiating a trial dose or attributing presenting signs with environmental stressors. Appetite stimulants tend to work only short-term and, based on clinical experience, may create a false sense of security if clients are not calculating exactly how many calories the pet is consuming to meet the resting energy requirement (RER). If the cat is stressed or nauseous, forced feeding or coax feeding may cause food aversion, so placement of a feeding tube is indicated in this case. Nasogastric tubes are not recommended for long-term needs or for use outside a hospital setting¹⁴, as cats can remove them. Also of note, because only a liquid diet can be used with nasogastric tubes, they are less versatile for nutrition options. 

Current recommendations are to initiate calorie intake at 10% to 25% of the RER and gradually increase the RER percentage to 100% over 5 to 7 days.¹⁵ In severely malnourished patients, feeding too quickly could increase the risk for refeeding syndrome. Additionally, illness factors, which were previously recommended to provide additional calories for pets that are ill, are no longer recommended for hospitalized patients.¹⁴ Finally, fat content has not been shown to be a factor for hepatic lipidosis, but based on clinical experience, cats and owners are more compliant with the smallest volume possible, which is usually met by a high-fat, high-calorie critical care diet.

The correct answer is A.

An overweight cat with a prolonged history of anorexia is at increased risk for hepatic lipidosis. Given that the cat was previously healthy and now has muscle wasting is a clinical sign that immediate intervention is required rather than initiating a trial dose or attributing presenting signs with environmental stressors. Appetite stimulants tend to work only short-term and, based on clinical experience, may create a false sense of security if clients are not calculating exactly how many calories the pet is consuming to meet the resting energy requirement (RER). If the cat is stressed or nauseous, forced feeding or coax feeding may cause food aversion, so placement of a feeding tube is indicated in this case. Nasogastric tubes are not recommended for long-term needs or for use outside a hospital setting¹⁴, as cats can remove them. Also of note, because only a liquid diet can be used with nasogastric tubes, they are less versatile for nutrition options. 

Current recommendations are to initiate calorie intake at 10% to 25% of the RER and gradually increase the RER percentage to 100% over 5 to 7 days.¹⁵ In severely malnourished patients, feeding too quickly could increase the risk for refeeding syndrome. Additionally, illness factors, which were previously recommended to provide additional calories for pets that are ill, are no longer recommended for hospitalized patients.¹⁴ Finally, fat content has not been shown to be a factor for hepatic lipidosis, but based on clinical experience, cats and owners are more compliant with the smallest volume possible, which is usually met by a high-fat, high-calorie critical care diet.

The correct answer is B.

Food allergies (immune-mediated reactions) and food intolerance (non–immune mediated) are typically presented nonseasonally in pets with pruritus and concurrent gastrointestinal clinical signs.¹⁶ In many cats, there is concurrent atopy and/or flea allergy dermatitis. Peer-reviewed studies have shown that the gold standard for a reliable diagnosis of food allergy is to feed a diet that will not cause clinical signs, followed by provocation testing to identify the causative protein source in a full dietary elimination trial.¹⁶ 

If a full dietary history can be obtained, a novel protein diet can be used for the dietary trial, which must be a protein source the patient has never been exposed to. Because of this cat’s extensive dietary history with a variety of protein sources, diets marketed as novel protein may not be novel in this case. Furthermore, any protein source can be a potential allergen, and no protein source has higher or lower antigenicity.¹⁶ Hypoallergenic is a marketing term that does not imply a diet with lower probability of causing allergy, as compared with other diets.  

Hydrolyzed therapeutic diets, however, are specially formulated, with the protein sources broken down to levels that will not stimulate an immune system reaction,¹⁶ which is why this option should be recommended. For healthy pets, helpful client handouts on selecting pet foods can be found at the World Small Animal Veterinary Association Nutrition Toolkit website.

Food allergies (immune-mediated reactions) and food intolerance (non–immune mediated) are typically presented nonseasonally in pets with pruritus and concurrent gastrointestinal clinical signs.¹⁶ In many cats, there is concurrent atopy and/or flea allergy dermatitis. Peer-reviewed studies have shown that the gold standard for a reliable diagnosis of food allergy is to feed a diet that will not cause clinical signs, followed by provocation testing to identify the causative protein source in a full dietary elimination trial.¹⁶ 

If a full dietary history can be obtained, a novel protein diet can be used for the dietary trial, which must be a protein source the patient has never been exposed to. Because of this cat’s extensive dietary history with a variety of protein sources, diets marketed as novel protein may not be novel in this case. Furthermore, any protein source can be a potential allergen, and no protein source has higher or lower antigenicity.¹⁶ Hypoallergenic is a marketing term that does not imply a diet with lower probability of causing allergy, as compared with other diets.  

Hydrolyzed therapeutic diets, however, are specially formulated, with the protein sources broken down to levels that will not stimulate an immune system reaction,¹⁶ which is why this option should be recommended. For healthy pets, helpful client handouts on selecting pet foods can be found at the World Small Animal Veterinary Association Nutrition Toolkit website.

The correct answer is B.

Food allergies (immune-mediated reactions) and food intolerance (non–immune mediated) are typically presented nonseasonally in pets with pruritus and concurrent gastrointestinal clinical signs.¹⁶ In many cats, there is concurrent atopy and/or flea allergy dermatitis. Peer-reviewed studies have shown that the gold standard for a reliable diagnosis of food allergy is to feed a diet that will not cause clinical signs, followed by provocation testing to identify the causative protein source in a full dietary elimination trial.¹⁶ 

If a full dietary history can be obtained, a novel protein diet can be used for the dietary trial, which must be a protein source the patient has never been exposed to. Because of this cat’s extensive dietary history with a variety of protein sources, diets marketed as novel protein may not be novel in this case. Furthermore, any protein source can be a potential allergen, and no protein source has higher or lower antigenicity.¹⁶ Hypoallergenic is a marketing term that does not imply a diet with lower probability of causing allergy, as compared with other diets.  

Hydrolyzed therapeutic diets, however, are specially formulated, with the protein sources broken down to levels that will not stimulate an immune system reaction,¹⁶ which is why this option should be recommended. For healthy pets, helpful client handouts on selecting pet foods can be found at the World Small Animal Veterinary Association Nutrition Toolkit website.

The correct answer is B.

Food allergies (immune-mediated reactions) and food intolerance (non–immune mediated) are typically presented nonseasonally in pets with pruritus and concurrent gastrointestinal clinical signs.¹⁶ In many cats, there is concurrent atopy and/or flea allergy dermatitis. Peer-reviewed studies have shown that the gold standard for a reliable diagnosis of food allergy is to feed a diet that will not cause clinical signs, followed by provocation testing to identify the causative protein source in a full dietary elimination trial.¹⁶ 

If a full dietary history can be obtained, a novel protein diet can be used for the dietary trial, which must be a protein source the patient has never been exposed to. Because of this cat’s extensive dietary history with a variety of protein sources, diets marketed as novel protein may not be novel in this case. Furthermore, any protein source can be a potential allergen, and no protein source has higher or lower antigenicity.¹⁶ Hypoallergenic is a marketing term that does not imply a diet with lower probability of causing allergy, as compared with other diets.  

Hydrolyzed therapeutic diets, however, are specially formulated, with the protein sources broken down to levels that will not stimulate an immune system reaction,¹⁶ which is why this option should be recommended. For healthy pets, helpful client handouts on selecting pet foods can be found at the World Small Animal Veterinary Association Nutrition Toolkit website.

The correct answer is B.

Food allergies (immune-mediated reactions) and food intolerance (non–immune mediated) are typically presented nonseasonally in pets with pruritus and concurrent gastrointestinal clinical signs.¹⁶ In many cats, there is concurrent atopy and/or flea allergy dermatitis. Peer-reviewed studies have shown that the gold standard for a reliable diagnosis of food allergy is to feed a diet that will not cause clinical signs, followed by provocation testing to identify the causative protein source in a full dietary elimination trial.¹⁶ 

If a full dietary history can be obtained, a novel protein diet can be used for the dietary trial, which must be a protein source the patient has never been exposed to. Because of this cat’s extensive dietary history with a variety of protein sources, diets marketed as novel protein may not be novel in this case. Furthermore, any protein source can be a potential allergen, and no protein source has higher or lower antigenicity.¹⁶ Hypoallergenic is a marketing term that does not imply a diet with lower probability of causing allergy, as compared with other diets.  

Hydrolyzed therapeutic diets, however, are specially formulated, with the protein sources broken down to levels that will not stimulate an immune system reaction,¹⁶ which is why this option should be recommended. For healthy pets, helpful client handouts on selecting pet foods can be found at the World Small Animal Veterinary Association Nutrition Toolkit website.