Effects of a high-protein, increased-fibre, dry diet supplemented with omega-3 fatty acids on quality of life in dogs undergoing chemotherapy.

Quality of life (QOL) in dogs with cancer is a key consideration in the assessment of cancer treatment options. Despite interest in dietary strategies to improve management of oncology patients, there have been very few clinical studies showing the impact of diet on adverse effects of chemotherapy in dogs. This study was a randomised, controlled, double-blinded, multicenter clinical trial to investigate a high-protein, increased-fibre diet supplemented with omega-3 fatty acids, for dogs with cancer undergoing standard-of-care chemotherapy. Client-owned dogs with newly diagnosed grade 2 or higher mast cell tumours (or non-resectable/incompletely resected tumours) or multicentric lymphoma were randomised to receive the test diet (n = 24) or control diet (n = 21) for 8 weeks. Primary outcomes were QOL assessments, faecal scores, and blood concentrations of C-reactive protein and monocyte chemoattractant protein-1. Of 12 QOL parameters, 10 significantly improved from baseline to Week 8 in the test group compared with one in the control group. However, differences between the two groups were only statistically significant for 'frequency of signs of illness' (P = .009). There were no significant differences in the incidence of any adverse events, including gastrointestinal adverse events or clinically significant differences in laboratory parameters or faecal scores between the two groups. The absence of an observed negative impact of the test diet, combined with the magnitude of QOL improvements associated with the diet, suggest that a larger trial is warranted.

Use of short videos and case studies to enhance student confidence in biochemistry knowledge and application in a large lecture biochemistry course in first year veterinary curriculum.

Large lecture courses are an efficient way to convey material to many students but have potential limitations, most notably the tendency for them to promote passive learning opportunities rather than active pedagogies. The curriculum at Cummings School of Veterinary Medicine at Tufts University, like many veterinary schools, contains many large lecture courses in the pre-clinical curriculum. This objective of this study was to use two active pedagogical interventions in a first-year lecture course named Veterinary Biochemistry and Metabolism that drew connections between basic science and several veterinary diseases. The first intervention targeted increasing students' intrinsic motivation and their confidence with understanding biochemistry concepts using videos created via collaborations between students, staff, and clinical and basic science faculty. The second intervention targeted active and collaborative learning via the implementation of clinical case studies completed in groups to relate lecture content to clinical scenarios with the aim of further enhancing student confidence in their knowledge of the material. To assess the effectiveness of these two interventions, pre-and post-course surveys using Likert style questions were administered to evaluate student confidence in the targeted concepts. The post-survey included open-ended responses on students' perspectives on their most important takeaways from the activities and their suggestions for improvements. The data showed a positive impact of these interventions on student motivation and confidence in their knowledge. This study provides support that targeted interventions to increase active learning strategies increase student engagement and may improve learning efficacy in large lecture courses.

Serum vitamin D status in sick cats with and without cholestatic liver disease.

OBJECTIVES: Vitamin D deficiency accompanies chronic cholestatic liver disease (CLD) in humans. The vitamin D status of cats with CLD is unknown. The objectives of this study were to describe serum vitamin D concentrations in cats with CLD and to determine if they correlated with indices of liver disease severity. METHODS: Thirty-six cats with CLD, defined by increases in serum bilirubin and serum alanine aminotransferase, and 23 sick cats with non-hepatobiliary diseases were prospectively enrolled. Serum 25-hydroxyvitamin D (25[OH]D), parathyroid hormone (PTH) and ionized calcium were measured. Signalment, clinical signs, comorbidities, diet history, serum bilirubin, liver enzyme activity, albumin, phosphorus, white blood cell count, prothrombin time and final hepatic cytologic/histopathologic diagnosis, when available, were recorded. RESULTS: Median serum 25(OH)D levels were similar in cats with CLD (89.5 nmol/l; range 21-112 nmol/l) and sick cats (89.0 nmol/l; range 49-115 nmol/l). Overall 12/36 (33%) cats with CLD and 4/23 (17%) sick cats had 25(OH)D levels below the lower limit of the reference interval (<65 nmol/l). Median PTH concentrations in cats with CLD were significantly higher (0.95 pmol/l; range 0-11.3 pmol/l) than in sick cats (0.70 pmol/l; range 0.5-6 pmol/l). In cats with CLD, 6/36 (17%) had high PTH levels in contrast to only 1/23 (4%) sick cats. In cats with CLD, 25(OH)D concentrations did not correlate with serum bilirubin, albumin or serum liver enzymes but were moderately negatively correlated with white blood cell count (r = - 0.402, P = 0.013). Cats with hepatic lipidosis had the highest prevalence of 25(OH)D concentrations that fell below the reference interval. CONCLUSIONS AND RELEVANCE: Many cats with CLD have serum 25(OH)D concentrations below the lower limit of the reference interval. Further study is warranted to determine the clinical relevance and whether supplementation would provide benefits.

Plasma amino acid and whole blood taurine concentrations in cats eating commercially prepared diets.

OBJECTIVE: To establish comprehensive reference ranges for plasma amino acid and whole blood taurine concentrations in healthy adult cats eating commercial diets and to evaluate the relationships of age, sex, body weight, body condition score (BCS), dietary protein concentration, and dietary ingredients with plasma amino acid and whole blood taurine concentrations. ANIMALS: 120 healthy adult cats. PROCEDURES: Blood samples and a complete health and diet history were obtained for each cat, and reference intervals for plasma amino acid and whole blood taurine concentrations were determined. Results were analyzed for associations of age, breed, sex, body weight, BCS, use of heparin, sample hemolysis and lipemia, dietary protein concentrations, and dietary ingredients with amino acid concentrations. RESULTS: 95% reference intervals were determined for plasma amino acid and whole blood taurine concentrations. A significant difference in amino acid concentrations on the basis of sex was apparent for multiple amino acids. There was no clear relationship between age, BCS, body weight, and dietary protein concentration and amino acid concentrations. Differences in amino acid concentrations were detected for various dietary ingredients, but the relationships were difficult to interpret. CONCLUSIONS AND CLINICAL RELEVANCE: This study provided data on plasma amino acid and whole blood taurine concentrations for a large population of adult cats eating commercial diets. Plasma amino acid and whole blood taurine concentrations were not affected by age, BCS, or body weight but were affected by sex and neuter status. Dietary protein concentration and dietary ingredients were not directly associated with plasma amino acid or whole blood taurine concentrations.

Assessment of the clinical accuracy of serum and saliva assays for identification of adverse food reaction in dogs without clinical signs of disease.

OBJECTIVE: To assess the clinical accuracy of 2 serum-based assays and 1 saliva-based assay for detection of adverse food reaction (AFR) in dogs without clinical signs of disease. ANIMALS: 30 healthy client-owned dogs. PROCEDURES: Dog owners completed an online survey to collect comprehensive information about their pets' diet history. From each dog, serum and saliva samples were obtained and submitted for AFR testing by means of 3 assays that assessed the immunoglobulin response to 24 foods. Assays A and B measured food allergen-specific IgE concentrations in serum, whereas assay C measured food allergen-specific IgA and IgM concentrations in saliva. Descriptive data were generated, and Fisher exact tests were used to assess the respective associations between positive test results and specific food ingredients to which dogs were exposed. RESULTS: Assays A, B, and C yielded positive results for 26, 18, and 30 dogs, respectively. All dogs had positive results for at least 1 assay. The median (range) number of foods or ingredients to which dogs tested positive was 10.5 (0 to 24) for assay A, 1 (0 to 13) for assay B, and 12.5 (4 to 22; IgM) and 3 (0 to 24; IgA) for assay C. Positive test results were not significantly associated with prior food exposure. CONCLUSIONS AND CLINICAL RELEVANCE: Saliva and serum assays for AFR often yielded positive results for apparently healthy dogs and are not recommended for clinical use. Elimination diet trials remain the gold standard for diagnosis of AFR in dogs.

Comparison of carbohydrate content between grain-containing and grain-free dry cat diets and between reported and calculated carbohydrate values.

Objectives The aim of this study was to compare the carbohydrate content of grain-containing and grain-free dry cat diets and compare major protein and carbohydrate sources of these diets. Methods This was a cross-sectional study of 77 randomly selected dry cat diets (42 grain-containing, 35 grain-free). Reported carbohydrate values were compared between grain-containing and grain-free cat diets. A subset of 25% of diets from each category (grain-containing and grain-free) was analyzed and nitrogen-free extract was calculated as an estimate of carbohydrate content. These calculated values were compared with reported values from the manufacturer. Animal- and plant-sourced ingredients were also compared between grain-containing and grain-free diets. Results Mean reported carbohydrate content of the grain-free diets (n = 35) was lower than the grain-containing diets (n = 41; 64 ± 16 vs 86 ± 22 g/1000 kcal; P <0.001). Reported carbohydrate values were higher than analyzed nitrogen-free extract (n = 20; 79 ± 30 vs 73 ± 27 g/1000 kcal; P = 0.024). Poultry ( P = 0.009) and soy (P = 0.007) were less common in grain-free diets than in diets containing grain. The alternative carbohydrate sources of chickpeas, lentils, peas, potato, sweet potato and cassava/tapioca were more common ( P <0.05) in grain-free diets than in diets containing grain. Conclusions and relevance This sample of grain-free diets had lower mean reported carbohydrate content than grain-containing diets, but there was considerable overlap between groups and individual diets' carbohydrate/nitrogen-free extract content varied widely.

Nutritional analysis and microbiological evaluation of commercially available enteral diets for cats.

OBJECTIVE: To determine the prevalence of nutrients less than or greater than accepted standards in commercially available enteral diets for cats, and to identify contamination incidence in enteral diets for cats. DESIGN: Prospective cross-sectional study. SETTING: University teaching hospital. SAMPLES: Seven commercial enteral diets for cats. INTERVENTIONS: Labels were evaluated to determine if diets were intended to be nutritionally complete and balanced. One diet under storage techniques partially representative of clinical conditions was sampled on days 0, 1, 3, 5, and 7 of storage for aerobic bacterial culture. MEASUREMENTS AND MAIN RESULTS: All 7 diets were analyzed for key nutrients and results were compared to Association of American Feed Control Officials (AAFCO) Nutrient Profiles for Adult Cats for maintenance and National Research Council recommended allowance (NRC-RA). From label information, 4 diets were classified as complete and balanced and 3 diets were classified as not complete and balanced. All 7 diets had at least 1 nutrient less than the AAFCO minimums and the NRC-RA. The total number of nutrients less than AAFCO minimums ranged from 3 to 9 (median = 4), with iron, potassium, and manganese being the most common. Concentrations of some nutrients were undetectable. None of the samples tested had a positive aerobic culture at baseline (day 0) or on subsequent samples from days 1, 3, 5, and 7 under any storage condition. CONCLUSIONS: None of the diets analyzed met all of the minimum nutrient concentrations. While short-term feeding may not be of concern for an individual patient, clinicians should be aware of potential nutritional limitations when feeding enteral diets to ill or injured cats.

Survey of dietary and medication practices of owners of cats with chronic kidney disease.

The objective of this study was to describe the dietary and medication patterns of cats with chronic kidney disease (CKD). In this prospective, cross-sectional descriptive study, owners of cats with CKD were asked to complete a web-based survey. The study was advertised on CKD-, pet-, veterinary- and breed-associated websites and list serves. Owners of 1089 cats with CKD participated in the study. The mean reported age of the cats with CKD was 13.7 ± 4.2 years. Forty percent (430/1089) of cats had concurrent diseases, with hyperthyroidism, heart disease and inflammatory bowel disease being the most common. Veterinarian recommendation was the most common reason reported (684/1032; 66%) for diet selection, and 51% (556/1089) of owners fed a veterinary therapeutic diet formulated for kidney disease as some component of the diet. Many owners (466/1079; 43%) reported that their cats had an abnormal appetite; of these owners, 52% responded that their cats had a poor appetite or required coaxing to eat 5-7 days per week. Forty-seven percent and 51% of cats were receiving subcutaneous fluids and oral medications, respectively; however, most cats (811/1036; 78%) were not receiving phosphorus-binding medications. Fifty-six percent and 38% of cats received commercial cat treats and dietary supplements, respectively. Anorexia or hyporexia is a common problem in cats with CKD and may lead to cats being fed suboptimal diets for their disease. This information may be useful for treating or designing nutritional studies for cats with CKD.

Evaluation of marketing claims, ingredients, and nutrient profiles of over-the-counter diets marketed for skin and coat health of dogs.

OBJECTIVE: To evaluate marketing claims, ingredients, and nutrient profiles of over-the-counter diets marketed for skin and coat health of dogs. DESIGN: Cross-sectional study. SAMPLE: 24 over-the-counter dry and canned diets marketed for skin and coat health of dogs. PROCEDURES: Data on marketing claims and ingredients were collected from diet packaging and manufacturer websites. Concentrations of selected nutrients were obtained by contacting the manufacturers and were compared against minimum values for Association of American Feed Control Officials Dog Food Nutrient Profiles for adult dog maintenance based on calorie content. RESULTS: Most diets incorporated marketing terms such as digestive health, sensitive, or premium that are poorly defined and may have limited relevance to skin, coat, or general health. The types and numbers of major ingredients (ie, potential to contribute protein to the diet) differed. The total number of unique major ingredients in each diet ranged from 3 to 8 (median, 5.5), but the total number of unique ingredients in each diet ranged from 28 to 68 (median, 38). Concentrations of nutrients associated with skin and coat condition also differed widely. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the large variation among over-the-counter diets marketed for skin and coat health may cause confusion for owners during diet selection. Owners of a dog with dermatologic problems should consult their veterinarian to select a good-quality diet that meets specific nutrient goals.

Analysis of thiamine concentrations in commercial canned foods formulated for cats.

OBJECTIVE: To measure thiamine concentrations in commercial canned foods formulated for cats as an initial assessment of the variation among canned foods and to determine the effects of flavor (fish vs nonfish) of the food, texture (paté vs nonpaté) of the food, country of manufacture, and size of the company on thiamine concentration. DESIGN: Prospective cross-sectional study. SAMPLE: 90 canned, nontherapeutic diets formulated for cats (1 fish and 1 nonfish flavor for each of 45 brands). PROCEDURES: Each canned food was homogenized, and thiamine concentration was analyzed with a fluorometric method. RESULTS: Thiamine concentration was below the minimums of the Association of American Feed Control Officials in 12 of 90 (13.3%) foods and below the recommended allowance of the National Research Council in 14 of 90 (15.6%) foods. Paté foods had significantly lower thiamine concentrations than did nonpaté foods, and foods from smaller companies had significantly lower thiamine concentrations, compared with concentrations in foods from larger companies. Flavor of food and country of manufacture were not significantly associated with thiamine concentration. CONCLUSIONS AND CLINICAL RELEVANCE: A wide range of thiamine concentrations was found in the foods evaluated. Thiamine concentration in a substantial percentage of commercially available canned foods was below the amount recommended for adult cats. Additional research on interlot and intralot variation in thiamine concentrations of foods formulated for cats is warranted. Companies should implement strict quality control and analysis practices regarding food products. Clinicians should consider thiamine deficiency as a differential diagnosis in a cat with acute neurologic dysfunction.

Feeding practices of dog breeders in the United States and Canada.

OBJECTIVE: To determine the proportion of dog breeders who fed diets meeting the Association of American Feed Control Officials regulations for nutritional adequacy for reproduction and growth and to investigate factors that influenced feeding practices of breeders. DESIGN: Web-based cross-sectional survey. SAMPLE: 2,067 dog breeders from the United States and Canada. PROCEDURES: A self-administered, anonymous, Web-based questionnaire was used to collect information on breeder demographics and feeding practices during 3 life stages of dogs: adult maintenance for nonpregnant dogs, gestation-lactation, and puppy growth. Appropriateness of commercial diets for each life stage was determined by respondent-reported nutritional adequacy statements on product labels. Data were also collected regarding breeder criteria for diet selection and sources of nutrition information. RESULTS: A substantial number of breeders reported feeding commercial diets not intended for that life stage during gestation-lactation (126/746 [16.9%]) and puppy growth (57/652 [8.7%]). Additionally, approximately one-seventh of breeders reported feeding home-prepared diets for ≥ 1 life stage. Unsubstantiated health and marketing information influenced diet selection of many breeders. Veterinarians, although generally viewed as a trusted source of nutrition information, were consulted by only 823 of 1,669 (49.3%) breeders and were viewed less favorably by breeders feeding home-prepared diets, compared with the opinion of breeders feeding commercial diets. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinarians should consider taking a more proactive role in directing dog breeders and other pet owners toward scientifically substantiated sources of diet information and in explaining the importance of current nutritional standards for reproduction and early development of dogs.

Comparison of the nutrient composition of commercial dog milk replacers with that of dog milk.

OBJECTIVE: To compare the nutrient composition of commercially available dog milk replacers with that of dog milk. DESIGN: Prospective, cross-sectional study. SAMPLE: 5 dog milk samples and 15 samples of commercial dog milk replacers. PROCEDURES: Dog milk and milk replacers were analyzed for concentrations of total protein, essential amino acids, sugars, total fat, essential fatty acids, calcium, and phosphorus. Energy density was calculated. Results from milk replacers were compared with the range of the concentration of each nutrient in milk samples from mature dogs as well as the National Research Council (NRC) recommendations for puppy growth. RESULTS: Milk replacers varied widely in caloric density and concentration of nutrients such as calcium, protein, and fat. Calcium concentration was lower in 14 of 15 milk replacers than in the dog milk samples. Docosahexaenoic acid was undetectable in 12 of 15 milk replacers but present in all dog milk samples. All milk replacers had numerous essential nutrients outside of the range of the dog milk samples, and many had concentrations of amino acids, essential fatty acids, calcium, and phosphorus less than the NRC minimal requirement or recommended allowance. Compared with NRC recommendations, some dog milk samples had concentrations of total protein, linoleic acid, calcium, or phosphorus less than the recommended allowance. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that there was substantial variation in nutrient composition of 15 dog milk replacers and that some products were closer approximations of dog milk than others. Nearly all products would benefit from more appropriate calcium, amino acids, and essential fatty acids concentrations and better feeding directions.

Effect of diet on brain metabolites and behavior in spontaneously hypertensive rats.

Attention-deficit hyperactivity disorder (ADHD) is a heterogeneous psychiatric disorder affecting 5-10% of children. One of the suggested mechanisms underlying the pathophysiology of ADHD is insufficient energy supply to neurons. Here, we investigated the role of omega 3 fatty acids in altering neural energy metabolism and behavior of spontaneously hypertensive rats (SHR), which is an animal model of ADHD. To this end, we employed Proton Magnetic Resonance Spectroscopy ((1)H MRS) to evaluate changes in brain neurochemistry in the SHR following consumption of one of three experimental diets (starting PND 21): fish oil enriched (FOE), regular (RD) and animal fat enriched (AFE) diet. Behavioral tests were performed to evaluate differences in locomotor activity and risk-taking behavior (starting PND 44). Comparison of frontal lobe metabolites showed that increased amounts of omega 3 fatty acids decreased total Creatine levels (tCr), but did not change Glutamate (Glu), total N-Acetylaspartate (tNAA), Lactate (Lac), Choline (Cho) or Inositol (Ino) levels. Although behavior was not significantly affected by different diets, significant correlations were observed between brain metabolites and behavior in the open field and elevated plus maze. SHR with higher levels of brain tCr and Glu exhibited greater hyperactivity in a familiar environment. On the other hand, risk-taking exploration of the elevated plus maze's open arms correlated negatively with forebrain tNAA and Lac levels. These findings support the possible alteration in energy metabolites in ADHD, correlating with hyperactivity in the animal model. The data also suggest that omega 3 fatty acids alter brain energy and phospholipid metabolism.

Comparison of complication rates in dogs with nasoesophageal versus nasogastric feeding tubes.

OBJECTIVE: To compare complication rates between nasoesophageal (NE) and nasogastric (NG) feeding tubes in dogs. DESIGN: Retrospective study. SETTING: University referral veterinary hospital. ANIMALS: A total of 46 dogs that were fed through a NE (n = 28) or NG (n = 18) tube between January 2007 and December 2011 and that also had either thoracic radiography or computed tomography performed so that location of the distal tip of the tube in either the esophagus or stomach could be confirmed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The medical record of each eligible case was reviewed and data recorded included signalment, underlying disease, body weight, body condition score, medications, duration of feeding, diet used, and complications observed (ie, vomiting, regurgitation, diarrhea, early tube removal, clogged tube, epistaxis, pulmonary aspiration, hyperglycemia, and refeeding syndrome). Dogs with NE tubes were significantly younger than dogs with NG tubes (P = 0.03) but there were no other significant differences in signalment, underlying disease, medications, duration of anorexia, percent of resting energy requirement achieved, or change in weight during tube feeding. There also was no significant difference between the NE and NG groups for any of the recorded complications. Significantly fewer dogs in the NE group died or were euthanized (3/28) compared to the NG group (7/18; P = 0.02) but outcome was not associated with age, underlying disease, or any of the recorded tube complications. CONCLUSIONS: This study did not identify a difference in complication rate between NE and NG feeding tubes in dogs. Additional studies are required to determine the optimal terminal location of feeding tubes in dogs.

Evaluation of recipes for home-prepared diets for dogs and cats with chronic kidney disease.

OBJECTIVE: To evaluate recipes of diets recommended for animals with chronic kidney disease (CKD), compare nutritional profiles for those recipes to requirements for adult dogs and cats, and assess their appropriateness for the management of CKD. DESIGN: Evaluation study. SAMPLE: Recipes of 67 home-prepared diets promoted for use in dogs (n = 39 recipes) and cats (28) with CKD. PROCEDURES: Recipes were analyzed with computer software to determine calories, macronutrient calorie distribution, and micronutrient concentrations and were assessed for appropriateness for the management of CKD. RESULTS: Assumptions were required for the analysis of every recipe, and no recipe met all National Research Council nutrient recommended allowances (RA) for adult animals. Compared with RAs, concentrations of crude protein or at least 1 amino acid were low in 30 of 39 (76.9%) canine recipes and 12 of 28 (42.9%) feline recipes. Choline was most commonly below the RA in both canine (37/39 [94.9%]) and feline (23/28 [82.1%]) recipes; selenium (34/39 [87.2%] canine and 9/28 [32.1 %] feline recipes), zinc (24/39 [61.5%] canine and 19/28 [67.9%] feline recipes), and calcium (22/39 [56.4%] canine and 7/28 [25.0%] feline recipes) concentrations were also frequently below recommendations. The median phosphorus concentration in canine and feline recipes was 0.58 and 0.69 g/1,000 kcal, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Many problems with nutritional adequacy were detected, and use of the recipes could result in highly variable and often inappropriate diets. Many recipes would not meet nutritional and clinical needs of individual patients and should be used cautiously for long-term feeding.