Ketogenic diets: A systematic review of current scientific evidence and possible applicability in dogs and cats.

Ketogenic diets (KD) have been used in the treatment of epilepsy in humans for around a century and, more recently, they have been implanted for cancer patients, as well as in the treatment of obesity. This type of diet consists of high-fat levels, an adequate amount of protein and restricted carbohydrates, or high medium-chain triglycerides. Recently, the ketogenic diet has gained attention in veterinary medicine and studies were published evaluating the effects of KD in dogs with epilepsy. The objective of this review was to highlight recent studies about the application of KD in dogs and cats, to describe the neurobiochemical mechanisms through which KD improves epilepsy crisis, and their adverse effects. Studies were identified by a systematic review of literature available on PubMed, Embase, and Scopus. All cohort and case-control studies were included, and all articles were exported to Mendeley® citation manager, and duplicates were automatically removed. Seven articles and three conference abstracts conducted with dogs were included in the present study. There is evidence that the consumption of diets with medium-chain triglycerides increases the concentration of circulating ketone bodies and improves epilepsy signs, although these diets have higher carbohydrate and lower fat content when compared to the classic KD.

Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet.

This observational study aimed to evaluate serum and urinary amino acid (AA) concentrations in healthy dogs and dogs with chronic kidney disease (CKD) fed a commercial therapeutic renal diet with reduced protein and phosphorus levels. Ten dogs with CKD stages 3 or 4 composed the study group and received the renal diet for 180 days (RG T180). A control group (CG T30) composed of seven healthy dogs was fed a renal diet for 30 days. When comparing serum AA between RG T180 and CG T30, histidine, isoleucine, leucine, lysine, phenylalanine, tryptophan, cysteine, citrulline, ornithine, taurine, branched-chain amino acids (BCAA), and total essential amino acids (EAA) were higher in RG T180. Meanwhile, arginine, asparagine, aspartate, glutamine, serine, and tyrosine were higher in CG T30. Serum phenylalanine, tryptophan, and hydroxyproline were higher in RG T0 (dogs with CKD before consuming a renal diet) when compared to RG T180. In addition, the serum ratios of arginine/citrulline, tyrosine/phenylalanine, and serine/glycine were higher in CG T30 than in RG T180. Concerning urinary AA concentrations in CKD dogs, isoleucine, phenylalanine, tryptophan, aspartate, cysteine, and BCAA were higher in RG T180. In urine, the total EAA/total non-essential AA ratio in RG T180 was higher than in CG T30 as well as tyrosine/phenylalanine ratio higher in CG T30. In conclusion, the combination of renal diet and conservative treatment over 6 months in dogs with CKD stages 3 or 4 affected the AAs metabolism when compared to healthy adult dogs.

Effects of Saccharomyces cerevisiae cell wall addition on feed digestibility, fecal fermentation and microbiota and immunological parameters in adult cats.

BACKGROUND: This study aimed to evaluate the effects of increasing dosages of a commercial product composed by Saccharomyces cerevisiae yeast (YAM), with active metabolites, which are beta glucans, nucleotides, organic acids, polyphenols, amino acids, vitamins and minerals (Original XPCtm, Diamond V, IOWA, USA) added to a commercially available dry cat food. Apparent digestibility of dietary nutrients, fecal microbiota, fecal fermentation products and immunological parameters were evaluated. Twenty-seven healthy cats of mixed sexes, with a mean body weight of 4.19 ± 0.83 kg and a mean age of 9.44 ± 5.35 years were distributed by age in an unbalanced randomized block design, consisting of three experimental treatments: CD (control diet), YAM 0.3 (control diet with 0.3% yeast with active metabolites) and YAM 0.6 (control diet with 0.6% yeast with active metabolites). RESULTS: The inclusion of the additive elevated the apparent digestibility of crude fiber (p = 0.013) and ash (p < 0.001) without interfering feed consumption, fecal production and fecal characteristics. Regarding fermentation products present in the feces, prebiotic inclusion increased lactic acid concentration (p = 0.004) while reducing isovaleric acid (p = 0.014), only in the treatment YAM 0.3. No differences were noticed on biogenic amines (BA), fecal pH, ammonia concentration, total and individuals short-chain fatty acids (SCFA) and total and individuals branched-chain fatty acids (BCFA) (except isovaleric acid in YAM 0.3). As regards to fecal microbiota, prebiotic inclusion has resulted in the reduction of Clostridium perfringens (p = 0.023). No differences were found in the immunological parameters evaluated. CONCLUSION: It can be concluded that the additive, at the levels of inclusion assessed shows prebiotic potential and it has effects on fecal fermentation products and microbiota without interfering on crude protein and dry matter digestibility. More studies evaluating grater inclusion levels of the prebiotic are necessary to determine optimal concentration.

Predictive equations of maintenance energy requirement for healthy and chronically ill adult dogs.

Maintenance energy requirement (MER) is the energy amount necessary for dogs to maintain their weight and body condition. Some factors can influence the MER, such as gender, age, neutering status and also diseases. The present retrospective study aimed to evaluate MER of adult dogs with several diseases and compare with the MER of healthy adult dogs, observing the influence of parameters such as body condition score (BCS), neutering status, gender, age, diagnosis and type of food on MER of these dogs. A total of 165 adult dogs with weight changes of ≤5% were included and divided in groups according to diagnosis. Mean MER for healthy dogs was 86.09 kcal/BW0.75 , which differed from NRC and FEDIAF recommendations for inactive adult dogs (p = .047). Lowest MERs were of the endocrinopathies (78.52 ± 19.32 kcal/BW0.75 ), orthopaedic diseases (59.71 ± 19.30 kcal/BW0.75 ) and neurologic diseases (78.83 ± 32.66 kcal/BW0.75 ) groups. Gastrointestinal diseases (99.59 ± 20.36 kcal/BW0.75 ), orthopaedic diseases (59.71 ± 19.30 kcal/BW0.75 ) and neoplasia (95.61 ± 21.02 kcal/BW0.75 ) groups were the only groups that differed from the mean MER of healthy adult dogs. Regarding BCS, for each increasing point in a 9-point scale, there was a decrease of 9.8 kcal/BW0.75 on MER, independent of diagnosis (p < .0001; r2  = .55). There was no difference regarding breed size gender and age, but neutered dogs presented lower MER (p = .031). Based on data obtained from the present study, it can be concluded that it is necessary to consider BCS, age, neutering status and diagnosis when calculating MER, both in healthy dogs and chronically ill dogs.

Gene expression of the immunoinflammatory and immunological status of obese dogs before and after weight loss.

Obesity is characterized by a low degree of chronic inflammation state that, along with metabolic modifications, promotes important changes in the animal's organism. Adipose tissue actively participates in inflammation and immunity, and several defense cells of the organism may, therefore, be involved in the diversity found between obese and ideal weight individuals. Studies regarding this subject have shown immune cell changes in humans and rats, however, the literature is scarce in relation to dogs. Thus, the present study aimed to evaluate the gene expression profile of immunoinflammatory response and the lymphoproliferation of obese dogs before and after weight loss. Eight female dogs, neutered, of different breeds, aged between 1 and 8 years (4.74±3.19), obese, with body condition score (BCS) of 9 out of a 9-point scale and body composition determined by the deuterium isotope dilution method were included. The obese dogs were enrolled in a weight loss program and after losing 20% of their initial weight became a second experimental group. A third experimental group consisted of eight female dogs, neutered, aged between 1 and 8 years (3.11±0.78) and with ideal BCS (5 out of a 9-point scale). Gene expression of immunoinflammatory cytokines (resistin, leptin, adiponectin, TNF-α, IL-6, IL-8, and IL-10) was assessed by qRT-PCR and immunity was assessed by lymphoproliferative response using the flow cytometry technique. The data that presented normal distribution was evaluated by analysis of variance by the PROC MIXED of the SAS and when differences were detected, these were compared by the Tukey test. Regarding the gene expression data, the procedure PROC GLIMMIX was adopted and the methodology of generalized linear model was used, in which the Gama distribution proved to be adequate. Values of p<0.05 were considered significant. The mean weight loss period of the animals included in the study was 194.25 ± 28.31 days and the mean weekly weight loss rate was 1.02 ± 0.82%. The average fat mass, both in percentage (P<0.001) and in kilograms (P = 0.012), was higher in the obese group (40.88%; 8.91kg), returning to normal and without difference between the control group (19.16%; 3.01kg) and after weight loss (22.10%; 4.11kg). The weight loss program resulted in an increase in percentage of lean body mass (P = 0.001), 55.50% in obese animals vs 77.90% in obese dogs after weight loss, the latter with no difference when compared to the control group (80.84%). The obese group presented increased gene expression of resistin and IL-8 in relation to the weight loss group (P = 0.002). In adiponectin, the obese group presented increased mRNA gene expression when compared to the weight loss group (P = 0.003). The evaluation of lymphocyte proliferation showed differences between the group of obese animals before and after weight loss (P = 0.004). Weight loss resulted in an increase in the lymphoproliferation rate (18.48%) compared to obese dogs at the beginning of the study (10.71%). These results indicate that weight loss modulates the immunoinflammatory response of obese dogs and may present important benefits to health and longevity of dogs.

Markers of inflammation and insulin resistance in dogs before and after weight loss versus lean healthy dogs / Marcadores de inflamação e resistência à insulina em cães antes e depois da perda de peso versus cães saudáveis e magros

Chronic low-grade inflammation in obesity is characterized by an increased production of pro-inflammatory cytokines that contribute to insulin resistance. For this study body composition, markers of inflammation and of insulin resistance in dogs before and after weight loss were compared to those of lean dogs. Eleven client-owned obese adult dogs underwent a weight loss program with commercial dry food for weight loss and reached an ideal body condition score (BCS) six months after the beginning of the weight loss program. A Control Group of nine dogs with ideal BCS were selected for the comparison. Shapiro-Wilk test was used to test for normality, Mann Whitney were used for non-normally distributes data, and Student t-test was used for normally distributed parameters. In the Obese Group body fat decreased from 41.6% (30.7-58.6) to 29.1% (18.6-46.3) (P<0.01) and dogs maintained lean body mass throughout the weight loss program (P>0.05). Obese dogs presented higher concentration of fructosamine, triglycerides, insulin, IGF-1 and leptin than the Control Group before weight reduction (P<0.05). Serum concentrations of triglycerides, IL-2, IL-6, TNF-α, insulin, leptin and IGF-1 decreased after weight loss (P<0.01), and these concentrations were similar to the Control Group (P>0.05), except for leptin (P<0.001). No alteration on peptide YY was found. Leptin (r=0.60, P=0.01), fructosamine (r=0.44, P=0.02) and triglycerides (r=0.40, P=0.04) concentrations correlated with the reduction of body fat. Weight loss reduced the concentrations of inflammatory and insulin resistance markers and most parameters became similar to dogs that have always been lean, reinforcing the importance of weight loss in small animal practice.(AU)

A inflamação crônica de baixo grau na obesidade é caracterizada pela produção aumentada de citocinas pró-inflamatórias que contribuem para a resistência à insulina. Para este estudo a composição corporal e os marcadores de inflamação e de resistência à insulina em cães antes e após a perda de peso foram comparados aos de cães magros. Onze cães adultos obesos pertencentes a tutores foram incluídos em um programa de perda de peso com ração comercial hipocalórica e alcançaram escore de condição corporal (ECC) ideal seis meses após o início do regime. Um Grupo Controle de nove cães com ECC ideal foi selecionado para a comparação. O teste de Shapiro-Wilk foi usado para testar a normalidade, Mann Whitney foi usado para análise dos dados que não atenderam distribuição normal e o teste t de Student foi usado para parâmetros que atenderam a normalidade. No Grupo Obesidade, a gordura corporal diminuiu de 41,6% (30,7-58,6) para 29,1% (18,6-46,3) (P<0,01) e os cães mantiveram massa magra ao longo do programa de perda de peso (P>0,05). Cães obesos apresentaram maior concentração de frutosamina, triglicérides, insulina, IGF-1 e leptina do que o Grupo Controle antes da redução de peso (P<0,05). As concentrações séricas de triglicerídeos, IL-2, IL-6, TNF-α, insulina, leptina e IGF-1 diminuíram após a perda de peso (P<0,01) e, essas concentrações foram semelhantes ao Grupo Controle (P>0,05), com exceção da leptina (P<0,001). Nenhuma alteração no peptídeo YY foi encontrada. As concentrações de leptina (r=0,60; P=0,01), frutosamina (r=0,44; P=0,02) e triglicerídeos (r=0,40; P=0,04) correlacionaram-se com a redução da gordura corporal. A perda de peso reduziu as concentrações de marcadores inflamatórios e de resistência à insulina e a maioria dos parâmetros tornaram-se semelhante aos dos cães que sempre foram magros, reforçando a importância da perda de peso na prática clínica de pequenos animais.(AU)

Vitamin D metabolism in dogs and cats and its relation to diseases not associated with bone metabolism.

Due to the presence of receptors in the cells of numerous body tissues, vitamin D is associated with several physiological functions that go beyond calcium and phosphorus homoeostasis and control of bone metabolism in the body. In humans, several studies have associated lower vitamin D concentrations with numerous diseases, such as cancer, heart disease, autoimmune diseases and infectious diseases, and also with an increase in the total mortality rate of the population. Recently, this nutrient started to gain importance in veterinary medicine, and several articles have shown a correlation between low vitamin D status and diseases unrelated to bone metabolism. The present review aims to highlight the recent publications that investigated this relationship, bringing the evidence that exists so far in dogs and cats.

Evaluation of Electrolyte Concentration and Pro-Inflammatory and Oxidative Status in Dogs with Advanced Chronic Kidney Disease under Dietary Treatment.

An integrated study on the effect of renal diet on mineral metabolism, fibroblast growth factor 23 (FGF-23), total antioxidant capacity, and inflammatory markers has not been performed previously. In this study, we evaluated the effects of renal diet on mineral metabolism, oxidative stress and inflammation in dogs with stage 3 or 4 of chronic kidney disease (CKD). Body condition score (BCS), muscle condition score (MCS), serum biochemical profile, ionized calcium (i-Ca), total calcium (t-Ca), phosphorus (P), urea, creatinine, parathyroid hormone (PTH), FGF-23, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-α) and total antioxidant capacity (TAC) were measured at baseline (T0) and after 6 months of dietary treatment (T6). Serum urea, P, t-Ca, i-Ca, PTH, FGF-23, IL-6, IL-10, TNF-α and TAC measurements did not differ between T0 and T6. Serum creatinine (SCr) was increased at T6 and serum PTH concentrations were positively correlated with serum SCr and urea. i-Ca was negatively correlated with urea and serum phosphorus was positively correlated with FGF-23. Urea and creatinine were positively correlated. The combination of renal diet and support treatment over 6 months in dogs with CKD stage 3 or 4 was effective in controlling uremia, acid-base balance, blood pressure, total antioxidant capacity, and inflammatory cytokine levels and in maintaining BCS and MCS.

Effect of calcium sources in the diets of adult cats on urinary parameters and acid-base balance / Efeitos das fontes de cálcio na dieta de gatos adultos sobre parâmetros urinários e equilíbrio ácido-básico

Calcium is a macroelement that is part of the mineral composition of the diet of companion animals, and is considered a cation of strong alkalizing power, increasing urinary pH. Calcium salts have different solubilities and depending on the anion to which calcium is associated with, it can be more or less absorbed, modifying the pH of the urine. The aim of this study was to evaluate the efficiency of calcium sources on alkalinization of urinary pH, as well as excretion of urinary electrolytes and acid-base balance of adult cats. An extruded diet for cats was selected, and had 160mEq/kg of calcium from the sources of either calcium carbonate (CaCO3) or calcium gluconate (C12H22CaO14) added. In the control treatment there was no addition of calcium sources, resulting in three treatments. Nine adult cats were used, mixed breed, in two experimental periods, with six replicates per treatment. Animal average age was 4±1.3 years old and average weight was 3.96±0.71kg. The cats remained in metabolic cages for an adaptation period of seven days, followed by six days of urine total collection, with volume, density, pH and calcium concentration (g/d) measurements. The acid-base balance was studied by blood gas analysis of venous blood. The two sources of calcium alkalinized the urine (P<0.001). However, calcium gluconate had less alkalinization power compared to the calcium carbonate (P<0.05). Urinary calcium was not affected by treatments, and represented less than 0.5% of calcium intake. The experiment showed that calcium, although an alkaline cation and considered strong influencer of the EB of the diet, cannot be evaluated individually, because depending on its associated anion it may have greater or lesser influence on cats urine pH.(AU)

O cálcio (Ca) é um macroelemento que faz parte da composição mineral da dieta de animais de companhia. Este macroelemento é considerado um cátion de forte capacidade alcalinizante e, de acordo com a fonte e quantidade inclusa, pode aumentar o pH urinário. Os sais de cálcio têm diferentes solubilidades e dependendo do ânion ao qual o cálcio está associado, pode ser mais ou menos absorvido e assim, alterar o pH da urina. O objetivo deste estudo foi avaliar os efeitos de duas fontes de cálcio na alcalinização do pH urinário, bem como a excreção de eletrólitos urinários e o equilíbrio ácido-básico de felinos. Foi selecionada uma dieta extrusada para gatos e adicionados 160mEq/kg de cálcio das fontes carbonato de cálcio (CaCO3) ou gluconato de cálcio (C12H22CaO14). No tratamento controle, não houve adição de fontes de cálcio. Foram utilizados nove gatos adultos, de raças mistas, em dois períodos experimentais, com seis repetições por tratamento. Os animais apresentavam idade média de 4,0±1,3 anos e peso corporal médio de 3,96±0,71kg. Estes permaneceram em gaiolas metabólicas em período de adaptação durante sete dias, seguido de coleta total de urina durante seis dias. Nestas amostras foram aferidos o volume, densidade, pH e concentração de cálcio (g/d). O equilíbrio ácido-básico foi avaliado por hemogasometria em amostras de sangue venoso. As duas fontes de cálcio alcalinizaram a urina (P<0,001). No entanto, o gluconato de cálcio apresentou menor potencial de alcalinização em comparação ao carbonato de cálcio (P<0,05). O cálcio urinário não foi afetado pelos tratamentos e representou menos de 0,5% da ingestão de Ca. O experimento demonstrou que o cálcio, apesar de ser um cátion alcalinizante e influenciador do EB da dieta, não pode ser avaliado individualmente, porque dependendo do ânion associado, pode apresentar maior ou menor influência no pH da urina de gatos.(AU)

Nutritional composition and evaluation of different methodologies for fat determination in wet feed for dogs and cats / Composição nutricional e avaliação de diferentes métodos de determinação de gordura em alimentos úmidos para cães e gatos

As a consequence of the increasing number of dog and cat owners, the pet food industry is expanding the range of pet food products in the market. In order to obtain more necessary information about the wet food segment for dogs and cats, the aim of this study was to determine the nutritional composition, to evaluate the information declared on the labels, and to compare the composition with the FEDIAF recommendations for protein and fat. Furthermore, three different methodologies of fat analysis were compared: crude fat (CFa), crude fat after acid hydrolysis (CFAH), and fat content obtained with Ankom XT15 (ANKOM) to determine the most adequate method for fat determination in wet foods. Twenty-five wet food products were evaluated, 13 wet foods for dogs and 12 for cats. Centesimal composition analyses obtained in this study were compared with guaranteed analysis declared on the label and with FEDIAF minimum recommended requirements for each species. The results of the nutritional composition and the values described on the label and the evaluation of the three fat determination methods were compared using the mixed model test with repeated measurements in the same samples, respectively (p < 0.05) in the SAS program, evaluation of protein adequacy and fat content were analyzed by mathematical calculations of difference and proportion. No difference was observed between nutritional composition of wet foods and the values declared on the labels for the majority of the diets analyzed, and there was a predominance of products that exceeded FEDIAF minimum recommendations of protein and fat for both species. No difference was observed between the three methods of fat content evaluation (p = 0.68). It was concluded that wet foods evaluated in this study match the label information and FEDIAF nutrient requirement recommendations, considering recommended calorie intake. All three fat determination methodologies evaluated were similar, justifying the choice of the easiest or cheapest method.(AU)

Devido ao aumento do número de cães e gatos domiciliados, a indústria de alimentos para animais de estimação tem expandido a gama de produtos existentes no mercado de pet food. Para obter informações mais relevantes sobre o segmento de alimentos úmidos para cães e gatos, este trabalho determinou a composição nutricional, avaliou as informações declaradas nos rótulos e comparou a composição com as recomendações da Fediaf de proteína e gordura. Também foram comparadas três metodologias diferentes de análise de gordura: extrato etéreo (CFa), extrato etéreo após hidrólise ácida (CFAH) e teor de gordura obtido no analisador Ankom XT15 (ANKOM) para determinar o método mais adequado de avaliação de gordura em alimentos úmidos. Foram avaliadas 25 marcas de alimentos úmidos, 13 para cães e 12 para gatos. As análises de composição centesimal obtidas neste estudo foram comparadas com a informação nutricional declarada nos rótulos e com as necessidades mínimas recomendadas pela Fediaf para cada espécie. Os resultados da composição nutricional, os valores descritos no rótulo e a avaliação dos três métodos para determinação da gordura foram comparados com o emprego do teste t e modelo misto com medidas repetidas nas mesmas amostras, respectivamente (p < 0,05) no programa SAS. Já a avaliação da adequação nutricional de proteína e do teor de gordura foram analisados por cálculos matemáticos de diferença e proporção. Para a maioria dos alimentos avaliados não foi observada diferença entre a composição nutricional dos alimentos úmidos e os valores declarados em rótulo, e houve predominância de produtos que excederam as recomendações mínimas de proteína e gordura da Fediaf para ambas as espécies. Quanto às metodologias de extração de gordura, não foi observada diferença entre os três métodos avaliados (p = 0,68). Concluiu-se que os alimentos úmidos avaliados atendem às informações declaradas pelos fabricantes e também às recomendações nutricionais da Fediaf com base na ingestão energética recomendada. Em relação às metodologias avaliadas para determinação de gordura nestes alimentos, a similaridade entre tais resultados justifica o uso da técnica de maior facilidade ou de menor custo.(AU)