Page 511 - Small Animal Clinical Nutrition 5th Edition

Obesity 527

VetBooks.ir Box 27-10. Web-Based Programs for Table 27-11. Methods for determining ideal/optimal body

Obesity Management. weight.
1. Consult the patient’s medical record to determine if a body
condition score (BCS) of 3/5 was recorded with a simultane-
www.PetFit.com
ous ideal body weight.
This is a commercial pet food company sponsored free program 2. Consult the patient’s medical record to see if the patient’s
for determining ideal (target) body weight for overweight/obese body weight was recorded at about the time the patient
dogs and cats. The visuals in this program include a profile and reached one year of age. Such a body weight would likely be
near ideal (but not always). Thus, this method might not be as
dorsal view of a dog and cat with a slide bar beneath. The body
reliable as Method 1 above.
condition score of the initial view is 3/5. The patient’s current 3. Consult Table 27-3 in this text.
weight is entered and the slide bar is moved to the right (or left) to a. Determine patient’s current BCS and obtain current body
match the dimensions of the patient. After the operator is satisfied weight.
with the match, an ideal body weight is automatically calculated. b. Locate the current BCS and body weight in Table 27-3.
c. Note the weight in Table 27-3 that coincides with a BCS
of 3/5 in the same column.
Balance IT (info@dvmconsulting.com) 4. Consult web-based programs (Box-27-10).
Balance IT is a fee-based program designed to help veterinary
health care teams with calculation-based weight-loss feeding
plans. The user can select/enter all the foods a patient is current-
ly fed (based on the diet history) and the program will then deter- Table 27-12. Using ideal body weight to determine initial food
mine the caloric needs of the patient for weight loss. Users can dosage for controlled weight loss.
set the desired weight-loss rates and select the commercial
weight-loss food they wish to feed (along with any treats up to The following steps represent the process for estimating the ini-
10% of daily calories).The program calculates the amount to feed tial amount to feed for weight loss using ideal body weight:
and enters this information into a report to be printed for clients. 1. Determine the patient’s current weight and BCS.
2. Consult Table 27-3; for current BCS, find current weight and
Based on weight rechecks, the software adjusts the amount to read associated ideal weight (BCS 3/5) from same column.
feed the patient. 3. Determine RER for ideal weight (also from Table 27-3, imme-
diately below ideal weight) = initial estimated daily energy
intake.
4. Divide RER by the as fed energy density of selected food =
initial daily food dose.
14 provides more details and an example of this method. Box
27-10 includes a web-based program that will perform calcula- An example case follows:
An obese dog weighs 30 kg and has a BCS of 5/5. Consulting
tions based on the current food information obtained from the Table 27-3, we determine that the dog’s ideal body weight (BCS
diet history.This can be an excellent way to calculate the initial 3/5) is 22.5 kg. In Table 27-3, the RER for a 22.5-kg dog is
food dose if the recorded amount fed in the feeding history is located immediately below the weight. In this case it is 723
kcal/day.*
complete and accurate. If the food history is incomplete, the The food selected for weight loss provides 220 kcal/cup; 723
owner can be instructed to return home and record actual kcal/day ÷ 220 kcal/cup = 3.3 cups/day. This amount is a start-
amounts fed for a three-day period and either phone in the ing point and may need to be modified to achieve the desired
weight loss.
information or schedule a followup visit. Potential shortcom- Recheck body weight after two to three weeks. The weight-loss
ings of this approach include losing the attention and commit- target should be between 0.5 and 2% per week of initial obese
ment of the owners due to busy schedules, inaccurate owner body weight.
Key: BCS = body condition score (Figures 1-2 and 1-3), RER =
reports due to concerns of having been “feeding too much” and resting energy requirement.
having to convert volume measures to calories if energy densi- *To convert to kJ, multiply kcal by 4.184.
ty on a volume basis is not readily available.

CALCULATION BASED ON OBESE WEIGHT
A fourth method for determining the amount to feed for food to determine the actual daily amount to feed. Table 27-15
controlled weight loss is based on obese weight, which is more provides an example calculation using this method. Because the
straightforward to obtain than optimal weight. This method amount of lean body mass does not increase linearly with the
also includes a calculation for the amount of desired weekly degree of obesity, this method could overestimate the initial
weight loss. food dose for weight loss of very obese patients.
With this method, the DER for obese weight is calculated. A reminder: all four methods generate what should be con-
Then the caloric equivalent of adipose tissue to be lost per week sidered as starting points. Individual animals of the same
is determined using a target of 1 to 2% of weight loss per week. weight have a wide variation of energy requirements (Figure 1-
This weekly amount of desired calorie deficit is converted to a 5). Thus, in actual practice, individual animals are encountered
daily amount and is subtracted from the previously calculated that need the same, markedly fewer and, occasionally, marked-
DER to provide the daily number of calories to feed for con- ly more calories than product literature or calculations suggest.
trolled weight loss. After the caloric intake for weight loss is Caloric restriction may be insufficient to produce weight loss or
calculated, it is divided by the calorie content of the selected may even produce weight gain in some patients (Laflamme et