Veterinary Medicine - September 2007 - (Page 596)

Hyperlipidemia O P E E R - R E V I E W E D stricted to 5% of the daily caloric intake and changed to low-fat varieties (carrots or brown rice crackers).3,17 Evaluate the plasma triglyceride concentration four weeks after beginning a reduced-fat diet. If the reduction in triglycerides is inadequate, ask the owner about compliance (e.g. excess or inappropriate treats, access to other foods), reevaluate the diet’s fat content, and reevaluate the medical record to ensure other diseases were ruled out (especially hypothyroidism and hyperadrenocorticism). For patients with poor response to low-fat commercial diets, consultation with a nutritionist for a balanced ultra-low-fat home-cooked diet may be beneficial. When low-fat diets are not adequate, lipid-reducing pharmacologic agents can be considered. Pharmacologic intervention. Lipidlowering agents used in people include chitosan, omega-3 fatty acids, niacin, fibric acid derivatives, and statins.18 Evidence for their effectiveness and safety in veterinary medicine is lacking. Chitosan is a calorie-free, animalderived fiber supplement that not only passes through the intestines without being digested but also absorbs and removes fat.19 There are no clinical trials reporting the benefit or side effects of chitosan. Diets rich in omega-3 fatty acids TABLE 6 Selected Low-Fat Commercial Diets for Dogs and Cats* Type Dogs Eukanuba Veterinary Diets Restricted-Calorie Hill’s Prescription Diet r/d Canine Hill’s Prescription Diet r/d Canine Purina Veterinary Diets OM Overweight Management Purina Veterinary Diets OM Overweight Management Royal Canin Veterinary Diet Low Fat LF 20 Royal Canin Veterinary Diet Low Fat LF Cats Eukanuba Veterinary Diets Restricted-Calorie Hill’s Prescription Diet r/d Feline Hill’s Prescription Diet r/d Feline Hill’s Prescription Diet w/d Feline Purina Veterinary Diets OM Overweight Management Purina Veterinary Diets OM Overweight Management Royal Canin Veterinary Diet Feline Calorie Control *Information from manufacturers. Metabolizable Energy from Fat (%) 17 25 24 17.7 23.6 15.2 15.3 23 24 25 24 20.5 34.4 23.4 Dry Dry Canned Dry Canned Dry Canned Dry Dry Canned Dry Dry Canned Dry Niacin (100 mg/day in dogs) may also reduce hypertriglyceridemia by decreasing fatty acid release from adipocytes and reducing the VLDL production.3,10 Potential side effects of When low-fat diets are not adequate, lipid-reducing pharmacologic agents can be considered. can lower hypertriglyceridemia in people by decreasing the production of VLDLs.18 Menhaden oil can be used in dogs at a dosage of 200 mg/kg/day.3,10 niacin include erythema, pruritus, abnormal hepatic function test results, vomiting, and diarrhea.3,10 In our experience, these side effects and the lack of convincing evidence of efficacy limit niacin use in dogs and cats. Fibric acid derivatives lower triglycerides by stimulating lipoprotein lipase, which decreases the production of fatty acids and, in turn, reduces VLDL concentrations. 18 We commonly use gemfibrozil (Lopid— Pfizer) at a dosage of 200 mg/day in dogs and 10 mg/kg every 12 hours in cats.3,10 Potential side effects include abdominal pain, vomiting, diarrhea, myositis, and abnormal hepatic function test results.3,18 The statins can be used to lower VLDLs, LDLs, and HDLs in people.18 Statins are usually prescribed for hypercholesterolemia in people; however, they are modestly effective at lowering triglyceride concentrations.18 Adverse effects in people include lethargy, diarrhea, muscle pain, and hepatotoxicity. 596 September 2007 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - September 2007

Contents Letters Leading Off The Veterinary Medicine Interview: Dr. William J. Kay Idea Exchange Practical Matters Salivary Mucoceles in Cates: A Retropspective Study of Seven Cases Hyperlipidemia in Dogs and Cats Purina Insert The Latest Management Recommendations for Cats and Dogs with Nonketotic Diabetes Mellitus CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - September 2007

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