AAS, CVT, VTS (Nutrition)
Jessie graduated in 2009 from National American University with an Associate’s Degree in Applied Science with an emphasis in veterinary technology. After graduation, she worked in general practice in South Dakota. In 2010, she moved to Arizona and joined Desert Veterinary Medical Specialists in 2012. She found a passion for veterinary nutrition and earned a VTS in nutrition. Jessie was the president of the student chapter of NAVTA while in college, and has continued to be an active member of NAVTA and of the American Academy of Veterinary Nutrition Technicians. In her free time she loves to be outside with her pets, riding her bicycle, reading, and swimming with her dogs in the pool.Read Articles Written by Jessie Nelson
A 2017 report by the Association for Pet Obesity Prevention (APOP) found that more than 100 million dogs and cats in the United States are overweight.1 “The number of pets with clinical obesity continues to increase,” says APOP founder Ernie Ward, DVM. “We’re continuing to see more pets diagnosed with obesity rather than overweight. Clinical obesity results in more secondary conditions such as arthritis, high blood pressure, kidney disease, and certain forms of cancer. Pets with obesity also have reduced quality of life and shorter life expectancy.”1
Despite this troubling report, veterinary professionals struggle to discuss pet obesity with a client, usually because they fear offending or upsetting him or her. Compounding this issue is that when it comes to nutrition, clients tend to take advice from just about anyone but a veterinary professional. While 57% of pet owners reported seeking nutritional advice for their animals from veterinarians, according to the APOP survey, 77% of the respondents also reported getting nutritional information from online sources, pet stores, and friends.1 For these reasons, veterinary teams need to find alternative ways to avoid upsetting their clients and to gain their trust in communicating the best nutritional requirements for their patients.
Know What You’re Talking About
Every veterinary team member has learned that nutrition is the fifth vital assessment and that sound nutritional recommendations for patients should be included in every veterinary appointment. The nutritional assessment is a 2-part process that begins with a screening evaluation.2 Based on these findings, an extended nutritional evaluation may be required. The screening evaluation includes obtaining a history and performing a physical examination on every patient. An extended evaluation is essential when one or more nutrition-related risk factors are found or suspected based on the initial screening evaluation.3 In an ideal world, every dog and cat would be eating the exact requirements based on their life stage and the recommended requirements of the American Association of Feed Control Officials.3
Start the Conversation
One of the most common—and also extremely difficult—nutritional discussions to have is the weight loss conversation. Clients may not believe their pet is overweight, let alone realize how they contributed to their animal’s obesity.
It is important to get clients to realize that they play a huge part in why the animal is overweight or obese. It is also a topic that needs to be handled delicately. Discussing the results of objective tools, such as blood tests that indicate too much fat or radiology images that show “extra rolls,” can serve as a conversation starter. Explain that even a little extra weight can affect the pet’s quality of life.
A landmark lifetime study of Labrador retrievers showed that overweight dogs live almost 2 years less than normal-weight dogs.6 Because of these health risks, the veterinary team must ensure that the client agrees that weight loss needs to take place. Take the time to discuss the risks that obese dogs and cats develop:
- Cancers of all types, diabetes mellitus, heart disease, and hypertension
- Osteoarthritis and a faster degeneration of affected joints
- Urinary bladder stones
- Anesthetic complications (due to lower heat tolerance)4,5
Discuss, Inform, Educate
Once the veterinarian prescribes a nutritional plan, the veterinary nurse should work with the owner to implement it. Often, this includes a diet change with a goal of weight loss. Therapeutic diets aid in weight loss in a variety of ways: Higher fiber helps the patient feel full and satiated between meals; certain nutrients may also help avoid weight regain after weight loss; and some diets have nutrients that work synergistically and naturally with the pet’s unique metabolism.
Inform clients about potential advantages, risks, and concerns with specific foods and treats, especially with ones they may already be feeding. It is important to educate pet owners that reducing the amount of food in the patient’s normal diet is not a safe plan for weight loss because deficiencies in nutrients can occur.
Always use nonjudgmental language. Instead of asking, “Do you give Sadie treats or table scraps?” try asking, “Tell me about Sadie’s favorite human foods or snacks.” Framing the question this way shows the team understands and accepts the importance of treats in the client’s relationship with the pet. This is an important step in gaining a client’s trust and buy-in to a weight-loss program and nutritional counseling.
Therapeutic weight-loss diets are balanced to provide both adequate nutrients and energy requirements and are less calorically dense. No matter what diet is prescribed, include your recommendations on the amount and frequency of the diet being fed and account for any snacks and/or treats. Remember to write this down for the owner and document this in the patient’s medical record.
In addition to the nutritional plan, veterinary team members must also have a conversation about lifestyle changes. Avoid using words such as “fat,” “heavy,” or other negative terms. Remember, you are trying to create a clinic culture that presents nutritional and lifestyle changes in a compassionate and positive way. Rather than commenting, “It looks like Sadie is a couch potato,” ask, “What does Sadie like to do with you?” Guide the pet parent in understanding that weight loss is achieved by having more calories burned each day than what the animal consumes each day. Based on what activity the pet enjoys, suggest examples of how the pet owner can help the animal burn extra calories per day: an extra walk to the mailbox, for example, or longer play times.
Pet parents may enrich their pet’s nutritional experience by interacting with them at feeding times. Interactive food toys are wonderful in helping a pet burn extra calories. Encourage the pet owner to reward the pet with praise or extra head scratches rather than high-calorie treats. Having animals chase the kibbles they eat will also provide great benefits in weight loss as well as mental stimulation. The American Veterinary Medical Association advises that pet owners should eliminate table scraps and fattening, high-calorie treats; if food treats are given, they should be healthier ones and should be kept to a minimum. Treats should not make up more than 10% of the pet’s daily calories.7
It’s All in the Approach
The pet parent should be involved in the decision making and help define expectations when creating the nutritional plan. An excellent place to start is to teach the client how to evaluate the body condition score and muscle condition score.8,9 This can be effective in helping engage clients in their pet’s care.When pet parents feels like they are involved in the decision making, they are more likely to follow the veterinary team’s specific recommendations.
Try to uncover any issues that may limit compliance with the dietary recommendations. One of the challenges may include financial considerations. In this case, use a spreadsheet to show the daily cost of the recommended diet compared to the daily cost of the pet’s current diet, including treats and snacks. Many times, calculating the cost to feed per day shows owners that they will not be spending more in the long run.
Follow-up care and communication are key to ensuring owner compliance and to safely achieve the desired outcome. Proper weight loss can be achieved by 1% to 2% loss of body weight per week.9 Following up with clients helps determine whether the patient is losing weight too fast or too slow or whether there are other concerns. Within a day or two of the initial appointment, make a follow-up call. Schedule a recheck appointment 2 weeks after the initial nutritional screening. Monthly weight checks are also recommended to monitor gastrointestinal issues, changes in behavior, client acceptance, etc. These follow-up visits permit you to make adjustments to food intake as necessary.
The weight-loss conversations you have with clients may be challenging, but once you convince them that their pets will live a longer, healthier life, they’ll discover it was a conversation worth having.
- 2017 Pet Nutrition and Weight Management Survey for Pet Owners and Veterinary Professionals. Association for Pet Obesity Prevention. petobesityprevention.org/2017. Accessed January 29, 2019.
- Baldwin K, Bartges J, Buffington C, et al. AAHA nutritional assessment guidelines for dogs and cats. JAAHA 2010;46:285-296.
- AAFCO Dog and Cat Food Nutrient Profiles. Association of American Feed Control Officials. aafco.org/Portals/0/SiteContent/Regulatory/Committees/Pet-Food/Reports/Pet_Food_Report_2013_Midyear-Proposed_Revisions_to_AAFCO_Nutrient_Profiles.pdf. Accessed February 13, 2019.
- Williams K, Downing R. Obesity in dogs. VCA Hospitals. vcahospitals.com/know-your-pet/obesity-in-dogs. Accessed January 29, 2019.
- Williams K, Downing R. Obesity in cats. VCA Hospitals. vcahospitals.com/know-your-pet/obesity-in-cats. Accessed January 29, 2019.
- Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs. JAVMA 2002;220(9):1315-1320.
- Steps to help keep pets healthy as part of New Year’s resolutions. American Veterinary Medical Association. avma.org/News/PressRoom/Pages/Steps-to-Help-Keep-Pets-Healthy-as-Part-of-New-Years-Resolutions.aspx. Accessed February 13, 2019.
- Global nutrition guidelines. WSAVA. wsava.org/Guidelines/Global-Nutrition-Guidelines. Accessed February 13, 2019.
- Case L, Daristotle L, Hayek M, Raasch MF. Canine and Feline Nutrition. 3rd ed. Maryland Heights, MO: Mosby Elsevier; 2011:239-242, 313-343.