Healthcare experiences of people living with medically unexplained symptoms: a systematic review.

A diagnosis of medically unexplained symptoms (MUS) is made when a person reports a complaint for which no organic disease can be detected. People with MUS commonly present to primary care services in the UK; however, there is no consensus regarding the evidence base for care. This literature review explores the experiences of these patients when they interact with health services. The following themes emerged: experience of diagnosis; expectations; communication; and healthful relationships. People with MUS report negative experiences of health care. Nurses in primary care have an opportunity to provide person-centred care to support these patients, and research could explore the potential contribution of nurses working in primary care in the UK to support them and enhance the evidence base for practice.

2014 AAHA weight management guidelines for dogs and cats.

Communicating and implementing a weight management program for dogs and cats can be a challenging endeavor for veterinarians, but a rewarding one. An effective individualized weight loss program provides a consistent and healthy rate of weight loss to reduce risk of disease, prevent malnutrition, and improve quality of life. Weight loss is achieved with appropriate caloric restriction, diet selection, exercise, and strategies to help modify behavior of both the pet and client. This document offers guidelines and tools for the management of weight loss and long-term maintenance of healthy weight.

Dietary Features Are Associated with Differences in the Urinary Microbiome in Clinically Healthy Adult Dogs.

Nutrition plays an important role in shaping the gut microbiome composition, although the impact of diet on the urinary microbiome (i.e., urobiome) remains unknown. The aim of this pilot study was to discover how nutritional features affect the diversity and composition of the urobiome in dogs. Dietary histories were obtained for 15 clinically healthy adult dogs, including limited nutrient (protein, fat, crude fiber), commercial diet brand, and dietary diversity profiles. The urine samples were collected via cystocentesis, followed by sequencing of the bacterial 16S rRNA gene. The data were analyzed to determine associations between major nutrients and dietary sources with the urobiome's composition. The protein, fat, and crude fiber contents had no statistically significant effect on the alpha or beta diversity. However, the beta diversity values differed (PERMANOVA; p = 0.017, R2 = 0.10) between dogs fed one commercial diet brand compared to dogs consuming any other brand. The beta diversity values also differed (p = 0.019, R2 = 0.10) between dogs consuming more diverse daily diets compared to those consuming less diverse diets (≥3 or <3 unique food sources, respectively). Overall, the results of this pilot study suggest that diet might impact the urobiome and support further exploration of the relationship between diet and the urobiome's composition in dogs.

Senior Pet Nutrition and Management.

Senior dogs and cats commonly present to veterinary clinics for wellness examinations and for illness. Nutritional needs change in healthy elder pets compared with the young adult life stage. Veterinary health care teams must provide nutritional assessments and individual recommendations, recognizing there is no defined nutrient profile for seniors. Individual variation prevents a one-size-fits-all approach. Advancing age places pets at risk for developing medical conditions. Early detection can lead to earlier nutritional intervention to support recovery, health, and quality of life. However, comorbidities may present a nutritional conundrum, requiring prioritization of problems and nutritional triage to balance needs.

Teaching nutrition to the left and right brain: an overview of learning styles.

Functioning effectively as a veterinarian requires proficiency in multiple learning styles. Whether the goal is to design a nutrition course, plan a veterinary curriculum, or help students develop interpersonal, communication, and leadership skills, students benefit when content, design, and delivery are balanced to meet their learning-style preferences. An overview of four different learning style models is presented: the Myers-Briggs Type Indicator (MBTI), Kolb's Learning Style Model, the Felder-Silverman Learning Style Model, and the Herrmann Brain Dominance Instrument (HBDI). A whole-brain approach (HBDI) was used in the development and implementation of the small-animal clinical nutrition course at the University of Minnesota College of Veterinary Medicine. One educational objective of this course is to help students develop mental dexterity, increasing their proficiency in both their preferred and their less preferred modes of learning. The instructional goals are to deliver the content of the small-animal clinical nutrition course through exercises that meet the needs of learners in each thinking quadrant (left and right, cerebral and limbic) at least part of the time. Examples of exercises are presented to portray a balanced or whole-brain approach to teaching clinical nutrition.

Communicating with Pet Owners About Obesity: Roles of the Veterinary Health Care Team.

Obesity continues to be the most prevalent nutritional problem of dogs and cats as well as one of the most frustrating conditions to treat successfully. Educating and assigning roles to all members of the health care team will improve staff engagement and the consistency and effectiveness of nutritional counseling for preventive care and weight loss treatment plans. Excellent communication skills can be used to assess the client's ability to change and implement a weight loss plan at the right time in the right way to achieve better adherence and improve patient health.

Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chronic Kidney Disease Stages 2 to 4: The Pro View.

Renal diets have been the mainstay of therapy for cats with chronic kidney disease (CKD) for many decades. Clinical trials in cats with CKD have shown them to be effective in improving survival, reducing uremic crises, and improving serum urea nitrogen and phosphorous concentrations. It has shown that, when food intake is adequate, renal diets can maintain body weight and body condition scores for up to 2 years. Although some have questioned whether renal diets provide adequate protein and have advocated feeding higher-protein diets to cats with CKD, there is currently no convincing evidence in support of this proposal.

Increase the success of weight loss programs by creating an environment for change.

Veterinary professionals frequently recommend weight loss programs for pets, but success is often elusive. By learning techniques to assess clients' readiness for change, the veterinary team can apply communication tools and strategies to help clients overcome obstacles and barriers to sustainable change. With a better assessment of a client's ability to change, a weight loss plan can be implemented at the right time in the right way to achieve better adherence to the agreed-upon plan and improve patient health.