Page 517 - Small Animal Clinical Nutrition 5th Edition

Obesity 533

VetBooks.ir Box 27-13. Pharmacologic Approach to Obesity in Dogs: Dirlotapide.

Given the growing health problem of obesity in people, dogs and fecal material.
cats, pharmacologic investigations to manage obesity have been Weight-loss programs that incorporate MTP inhibitors will almost
underway for many years. There are numerous receptors in the certainly be successful initially and may help dogs with immediate
hypothalamus that have been identified as possible targets of a medical concerns related to excessive weight. But it is imperative
pharmacologic remedy to obesity. Hypothalamic receptors appear that weight-loss programs incorporating MTP inhibitors take
to be reasonable targets given the role of the hypothalamus in con- advantage of this initial short-term success and capitalize on the
trolling appetite, food intake and energy expenditure. opportunity to change owner behaviors, which will then foster long-
During dietary fat digestion and absorption, lipids enter an ente- term success. If this opportunity is not captured, weight gain
rocyte and are repackaged as chylomicrons by a microsomal tria- (rebound) will be inevitable when the MTP inhibitors are withdrawn
cylglycerol transfer protein (MTP). From there they are transferred because appetite returns within days of discontinuing the drug. If
a
to the lymphatics and blood. Dirlotapide is a MTP inhibitor that is used incorrectly, and not integrated into an overall plan of proper
highly selective for enterocytes when taken orally. Dirlotapide par- food, food dosage and exercise, weight loss with MTP inhibitors will
tially inhibits MTP resulting in an accumulation of lipid within the be cyclic and results will be just as frustrating as current programs.
mucosal cell lining. Triglyceride accumulation within enterocytes
triggers secretion of hypothalamic satiety hormones (PYY and GLP- ENDNOTE
1), which ultimately leads to a voluntary decrease of food and calo- a. Slentrol. Pfizer Animal Health, New York, NY, USA.
rie intake. The dirlotapide label insert states that the “...mechanism
for producing weight loss is not completely understood, but seems The Bibliography for Box 27-13 can be found at
to result from reduced fat absorption and a satiety signal from lipid- www.markmorris.org.
filled cells lining the intestine.” It has been estimated that 90% of
the weight lost is due to decreased food intake and 10% is due to Rebecca L. Remillard, PhD, DVM, Dipl. ACVN
reduced lipid absorption. Fecal fat increases in dogs given dirlotapi- MSPCA Angell Animal Medical Center
de because enterocytes containing fat are normally shed as part of Boston, MA, USA

Table 27-16. Levels of key nutritional factors in selected commercial foods marketed for weight maintenance in dogs after a weight-loss
program compared to recommended levels.*

Dry foods Energy Energy
density density Fat Fiber Prot Carb Carn Vit E Vit C Se Na P
(kcal/cup)** (kcal ME/g) (%) (%) (%) (%) (ppm) (IU/kg) (mg/kg) (mg/kg) (%) (%)
Recommended levels - ≤3.4 ≤14 10-20 ≥18 ≤55 ≥300 ≥400 ≥100 0.5-1.3 0.2-0.4 0.4-0.8
Hill’s Prescription Diet
w/d Canine 243 3.3 8.8 16.4 18.9 51.2 349.5 574 274 1.34 0.22 0.56
Hill’s Prescription Diet
w/d with Chicken Canine 239 3.2 8.7 17.1 19.1 50.1 328.0 611 298 1.52 0.27 0.56
Iams Veterinary Formula
Weight Control D/ 209 3.5 9.5 3.0 28.7 51.2 na na na na 0.51 1.00
Optimum Weight Control
Medi-Cal Weight Control/
Mature 320 na 8.5 4.0 19.5 na na na na na 0.2 0.8
Purina Veterinary Diets
OM Overweight 266 3.0 7.2 10.3 31.1 44.2 na na na na 0.31 0.89
Management
Moist foods Energy Energy
density density Fat Fiber Prot Carb Carn Vit E Vit C Se Na P
(kcal/can)** (kcal ME/g) (%) (%) (%) (%) (ppm) (IU/kg) (mg/kg) (mg/kg) (%) (%)
Recommended levels - ≤3.4 ≤14 10-20 ≥18 ≤55 ≥300 ≥400 ≥100 0.5-1.3 0.2-0.4 0.4-0.8
Hill’s Prescription Diet
w/d Canine 329/13 oz. 3.5 12.7 12.4 17.9 52.6 364.1 614 116 0.72 0.24 0.52
Medi-Cal Weight Control/
Mature 370/396 g na 10.0 5.5 21.5 na na na na na 0.3 0.6
Purina Veterinary Diets
OM Overweight 189/12.5 oz. 2.5 8.4 19.2 44.1 21.7 na na na na 0.28 1.06
Management
Key: ME = metabolizable energy, na = information not available from manufacturer, Fiber = crude fiber, Prot = protein, Carb = digestible
carbohydrate, Carn = L-carnitine, Se = selenium, Na = sodium, P = phosphorus, g = grams.
*From manufacturers’ published information or calculated from manufacturers’ published as-fed values. All values are on a dry matter
basis unless otherwise stated.
**Energy density values are listed on an as fed basis and are useful for determining the amount to feed; cup = 8-oz. measuring cup.
To convert to kJ, multiply kcal by 4.184.