Page 663 - Small Animal Clinical Nutrition 5th Edition

686 Small Animal Clinical Nutrition

Physical examination was unremarkable except for moderate
obesity (body weight 45 kg,body condition score [BCS] 4/5) and
VetBooks.ir abnormalities identified in the musculoskeletal system. The

range of motion of both hip joints was diminished, crepitation
was palpated and the dog reacted painfully when its hips were
extended. Neither hind limb could be abducted normally in the
sagittal plane when the dog was in dorsal recumbency. A thor-
ough examination of limbs and lumbosacral area revealed no
other abnormalities.
Radiographs of the coxofemoral joints confirmed a diagnosis
of severe osteoarthritis due to hip dysplasia (Figure 1).

Assess the Food and Feeding Method
The dog was fed four cups (1,500 kcal [6.28 MJ]) of a commer-
cial dry dog food and table foods. The dry food was fed once
daily.The table foods were leftovers from the childrens’ food; the
amount varied daily. The owners indicated the dog gained most
of its weight after an ovariohysterectomy two years earlier and
during the summer holidays when the dog spent a month with
the owners’ parents who lived in an apartment for retired people.
The food intake during that month was unknown.

Questions
1. What feeding plan should be implemented to improve the
condition of this patient?
2. What non-nutritional management practices can be used to
reduce the biomechanical stress on the hip joints of this
patient?

Answers and Discussion Figure 1. Ventrodorsal radiograph of a four-year-old Labrador
retriever with bilateral hip dysplasia. Degenerative joint disease is
1. The biomechanical stress induced by rapid weight gain during
evident in both coxofemoral joints. Note that the femoral heads have
growth has been cited as a popular etiology for canine devel- remodeling changes, the acetabuli are shallow and subchondral
opmental orthopedic disease (DOD). It is unknown, and sclerosis and osteophyte formation are present in the femoral and
somewhat contested, whether skeletal lesions occur first and acetabular components of the joint.
are then exacerbated by biomechanical stress, or if biomechan-
ical stress first induces cartilaginous lesions. In either case, increased static forces (excessive weight load) or dynamic forces (exces-
sive muscle pull) may damage immature skeletons.
In older overweight dogs with established osteoarthritis, biomechanical stress can be diminished with weight reduction.
Weight reduction should be continued until very little subcutaneous fat is evident (BCS 2/5).
Dietary fatty acid changes may provide antiinflammatory benefits that result in clinical improvement in some dogs with
osteoarthritis. Changing the food or adding a supplement can manipulate fatty acid levels in the diet.
2. Biomechanical stress on the hip joints can also be reduced through alterations in the exercise protocol for the dog. Exercise is an
important component of weight-loss and weight-control programs but must be carefully managed in patients with arthritis.
Swimming is an excellent form of exercise that builds cardiovascular endurance and hastens weight loss without overloading the
joints. Short, frequent walks on a leash should also be encouraged to prevent overloading of the joints, rather than long walks or
unsupervised exercise. Nonsteroidal antiinflammatory drugs can be prescribed as needed for joint pain and lameness.

Progress Notes
A weight-reduction program was outlined for the owners. All table scraps were eliminated and the owners chose to feed a reduced
quantity of the dog’s current food (two cups [750 kcal, 3.14 MJ] per day divided into two equal feedings).The owners were advised
to take the dog for daily swims or as often as possible. In addition, the owners walked the dog on a leash several times daily for
approximately 20 minutes or for shorter periods when they recognized the dog was having difficulty rising. The target weight loss
was 1% of body weight per week. The owners were instructed to return to the clinic every two weeks for body weight recordings
and reinforcement of the program.
The target weight of 35 kg was reached in four months with this controlled exercise and feeding plan. The owners reported the
dog could more easily accompany them on long walks. Few signs of lameness were present after the dog reached target weight.