Veterinary Medicine - September 2007 - (Page S5)

FIGHTING A GROWING TREND Buzhardt: I want to change behavior first. We're looking for a lifetime commitment to health. We don't want people to use the drug as a crutch. Rebounds in weight, which occur when behavior hasn’t changed, are not healthy for the pet. Remillard: I agree the drug would not be a firstline attack. I think that behavior modification is the underlying goal. But in our practice, because some of my owners have given weight loss a reasonable try, we might use it sooner than a primary care clinician. My preference is to use it with patients that have already tried diet change. The exception would be the more serious cases of morbid obesity or dogs that can't exercise because of surgery. They would get more immediate help. Churchill: We would probably start these dogs on the medication before the orthopedic procedure. We like to reduce weight before we repair that anterior cruciate ligament or replace that hip. It has a definite medical benefit. Laflamme: Would you change the diet then? Buzhardt: I would be reluctant to change the food at the same time because if the dog doesn't eat the new diet, then the owner really doesn’t know if it’s due to the medication or the diet. I would let the dog acclimate to the medication first so that any vomiting is attributed to the drug and not the diet. Certainly we want to make sure that they're being fed a good weight management diet before we stop the drug because rebound appetite and weight gain may occur. Laflamme: If the drug is working, food intake is going to be quite restricted in these dogs, which is what induces the weight loss. Dr. Churchill, with food restriction, what are your concerns about nutrient deficiencies? What kind of diet would you like to feed while this drug is being used? Churchill: When a patient is significantly overweight, I have concerns that an over-thecounter complete and balanced diet may not optimally meet the pet's nutritional needs when the amount is reduced to achieve weight loss. For example there is quite a range in protein content of complete and balanced “light” foods, with some being quite low in protein. Feeding these may lead to protein malnutrition. Although we need to assess these patients' health and nutritional needs on an individual basis, I anticipate they will need a therapeutic weightloss diet in addition to drug therapy. It may be a fine balance between the food and the medication to find the best balance for successful weight loss in challenging cases. Dr. Dottie Laflamme “An ideal weight-loss diet for most animals is low in fat and high in protein and fiber. If an animal cannot tolerate a high fiber diet, then using water to dilute calories is another alternative.” Developing feeding plans and weight-loss goals Laflamme: How do you set up a feeding protocol for an individual patient? Prendergast: We utilize the Purina software because it creates a detailed plan for the client, including how much to feed, how to use treats, and how many kilocalories to feed. If we don’t see the weight loss that we expect, it will recalculate and tailor the plan for us. It has our clinic name and our patient’s name on it, so it’s very client-oriented. Buzhardt: We specify what to feed, write it on the sheet, and ask that they bring it back every month. Laflamme: Are you targeting a particular rate of weight loss? Buzhardt: Yes. Our goal is about 3% body weight a month. That’s a healthy goal, and clients can actually see the benefits. Prendergast: We also hope for 2% to 3% body weight per month. Churchill: I think 1% per week or 4% per month is realistic. 5

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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