Cohort Study of the Success of Controlled Weight Loss Programs for Obese Dogs.

BACKGROUND: Most weight loss studies in obese dogs assess rate and percentage of weight loss in the first 2-3 months, rather than the likelihood of successfully reaching target weight. OBJECTIVE: To determine outcome of controlled weight loss programs for obese dogs, and to determine the factors associated with successful completion. ANIMALS: 143 obese dogs undergoing a controlled weight loss program. METHODS: This was a cohort study of obese dogs attending a referral weight management clinic. Dogs were studied during their period of weight loss, and cases classified according to outcome as "completed" (reached target weight), "euthanized" (was euthanized before reaching target weight), or "stopped prematurely" (program stopped early for other reasons). Factors associated with successful completion were assessed using simple and multiple logistic regression. RESULTS: 87/143 dogs (61%) completed their weight loss program, 11 [8%] died or were euthanized, and the remaining 45 [32%] stopped prematurely. Reasons for dogs stopping prematurely included inability to contact owner, refusal to comply with weight management advice, or development of another illness. Successful weight loss was positively associated with a faster rate (P < .001), a longer duration (P < .001), and feeding a dried weight management diet (P = .010), but negatively associated with starting body fat (P < .001), and use of dirlotapide (P = .0046). CONCLUSIONS AND CLINICAL RELEVANCE: Just over half of all obese dogs on a controlled weight loss program reach their target weight. Future studies should better clarify reasons for success in individual cases, and also the role of factors such as activity and behavioral modification.

Feeding obese dogs during weight loss is on average cost-neutral.

OBJECTIVES: The cost of feeding a purpose-formulated weight loss diet may deter owners of obese dogs from proceeding with a weight loss programme. The current study aimed to compare average food costs during weight loss with those before weight loss. MATERIALS AND METHODS: Average daily food costs, for before and during weight loss, were calculated in 22 obese dogs that had successfully completed weight management. RESULTS: The median food cost before weight loss was £0 · 52/day (£0 · 24-3 · 31/day), for main meal only, and £0 · 64/day (£0 · 26-3 · 31/day) for main meal and additional food (table scraps and treats). The median food cost during weight loss was £0 · 90/day (£0 · 26-1 · 36/day), and no additional food was given. The average daily feeding costs during weight loss did not differ from pre-weight-loss costs, either with (P = 0 · 425) or without (P = 0 · 222) the additional food included. CLINICAL SIGNIFICANCE: Knowledge that average diet costs do not significantly differ from food costs prior to weight loss may help veterinarians to persuade owners to enrol obese dogs in a weight management programme.

Oxygenation and ventilation characteristics in obese sedated dogs before and after weight loss: a clinical trial.

This prospective clinical study examined the effect of obesity and subsequent weight loss on oxygenation and ventilation during deep sedation in pet dogs. Data from nine dogs completing a formalised weight loss programme were evaluated. Dual-energy X-ray absorptiometry (DEXA) was used to quantify body fat mass prior to and after weight loss. Dogs were deeply sedated and positioned in dorsal recumbency. Sedation was scored using a semi-objective scheme. As part of the monitoring of sedation, arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2) were measured after 10 min in dorsal recumbency. Oxygen saturation of haemoglobin (SpO2) was monitored continuously using pulse oximetry, starting oxygen supplementation where indicated (SpO2<90%) via a face mask. Morphometric measurements were taken from DEXA images and compared before and after weight loss. Several oxygen indices were calculated and correlated with body fat variables evaluated by DEXA. All body fat variables improved significantly after weight loss. PaO2 increased from 27.9±19.2 kPa to 34.8±24.4 kPa, while FiO2 decreased from 0.74±0.31 to 0.66±0.35. Morphometric measurements improved significantly after weight loss. PaO2/FiO2 (inspired oxygen fraction) and Pa/AO2 (ratio of PaO2 to alveolar PO2) also improved significantly, but there was no change in f-shunt and PaCO2 after weight loss. On multiple linear regression analysis, all oxygen indices were negatively associated with thoracic fat percentage. In conclusion, obesity decreases oxygenation in dogs during deep sedation. Oxygenation status improves with successful weight loss, but ventilation is not influenced by obesity.

Ex vivo evaluation of the biomechanical effect of varying monocortical screw numbers on a plate-rod canine femoral gap model.

OBJECTIVE: To compare the biomechanical behaviour of plate-rod constructs with varying numbers of monocortical screws applied to an ex vivo canine femoral-gap ostectomy model. SAMPLE POPULATION: Twenty Greyhound dog cadaveric femurs. METHODS: Bone mineral density (BMD) was assessed with dual x-ray absorptiometry. Bones were assigned to four groups. Bones had a 12-hole 3.5 mm locking compression plate with one bicortical non-locking cortical screw in the most proximal and distal plate holes and an intramedullary Steinmann pin applied across a 20 mm mid-diaphyseal ostectomy. Additionally, one to four monocortical non-locking cortical screws were then placed (Groups 1-4 respectively) in the proximal and distal fragments. Stiffness and axial collapse were determined before and after cyclic axial loading (6000 cycles at 20%, 40%, and 60% of mean bodyweight [total: 18000 cycles]). Constructs subsequently underwent an additional 45000 cycles at 60% of bodyweight (total: 63000 cycles). Loading to failure was then performed and ultimate load and mode of failure recorded. RESULTS: The BMD did not differ significantly between groups. Construct stiffness for group 1 was significantly less than group 4 (p = 0.008). Stiffness showed a linear increase with an increasing number of monocortical screws (p = 0.001). All constructs survived fatigue loading. Load-to-failure was not significantly different between groups. Mean load- to-failure of all groups was >1350N. CLINICAL RELEVANCE: Ex vivo canine large-breed femurs showed adequate stability biomechanically and gradually increasing stiffness with increasing monocortical screw numbers.

Effect of weight loss in obese dogs on indicators of renal function or disease.

BACKGROUND: Obesity is a common medical disorder in dogs, and can predispose to a number of diseases. Human obesity is a risk factor for the development and progression of chronic kidney disease. OBJECTIVES: To investigate the possible association of weight loss on plasma and renal biomarkers of kidney health. ANIMALS: Thirty-seven obese dogs that lost weight were included in the study. METHODS: Prospective observational study. Three novel biomarkers of renal functional impairment, disease, or both (homocysteine, cystatin C, and clusterin), in addition to traditional markers of chronic renal failure (serum urea and creatinine, urine specific gravity [USG], urine protein-creatinine ratio [UPCR], and urine albumin corrected by creatinine [UAC]) before and after weight loss in dogs with naturally occurring obesity were investigated. RESULTS: Urea (P = .043) and USG (P = .012) were both greater after weight loss than before loss, whilst UPCR, UAC, and creatinine were less after weight loss (P = .032, P = .006, and P = .026, respectively). Homocysteine (P < .001), cystatin C (P < .001) and clusterin (P < .001) all decreased upon weight loss. Multiple linear regression analysis revealed associations between percentage weight loss (greater weight loss, more lean tissue loss; r = -0.67, r(2) = 0.45, P < .001) and before-loss plasma clusterin concentration (greater clusterin, more lean tissue loss; r = 0.48, r(2) = 0.23, P = .003). CONCLUSION AND CLINICAL IMPORTANCE: These results suggest possible subclinical alterations in renal function in canine obesity, which improve with weight loss. Further work is required to determine the nature of these alterations and, most notably, the reason for the association between before loss plasma clusterin and subsequent lean tissue loss during weight management.

Long-term follow-up after weight management in obese dogs: the role of diet in preventing regain.

Regain after weight loss is widely reported in humans, but there is little information on this phenomenon in dogs. The current study aim was to determine long-term success of a weight loss regime and those factors linked with regain. Thirty-three obese dogs, that had successfully lost weight, were included, all enrolled between December 2004 and May 2009. After weight loss, dogs were switched to a maintenance regime and follow-up weight checks were performed periodically. A review of cases that had completed their weight programme was held during the summer of 2010 and a follow-up check was subsequently conducted, where dogs were reweighed and information was collected on current feeding practices. Median duration of follow-up was 640 days (119-1828 days). Fourteen dogs (42%) maintained weight, 3 (9%) lost >5% additional weight, and 16 (48%) gained >5% weight. Dogs fed a purpose-formulated weight loss diet regained less weight than those switched onto a standard maintenance diet (P=0.0016). Energy intake at the time of follow-up was significantly higher in those dogs fed a standard maintenance diet, compared with those that had remained on a purpose-formulated weight loss diet (P=0.017). These results suggest that weight regain occurs in about half of dogs after successful weight loss. Long-term use of a purpose-formulated weight management diet can significantly limit regain in the follow-up period, likely by limiting food intake.

Effects of weight loss in obese cats on biochemical analytes related to inflammation and glucose homeostasis.

The aim of the current study was to measure circulating metabolic and inflammation-related biochemical analytes in obese cats before and after weight loss. Thirty-seven overweight neutered cats were studied, median body weight 6.85 kg (range, 4.70 to 10.30 kg), representing a range of ages and both sexes. An individualized weight-loss program was devised for each cat and monitored until completion. Body fat mass was determined by dual-energy x-ray absorptiometry, whereas plasma concentrations of acute-phase proteins (APPs; eg, haptoglobin and serum amyloid A), hormones (eg, insulin, IGF-1, and adiponectin), and enzymes (eg, butyrylcholinesterase and paraoxonase type 1 [PON-1]) associated with inflammation and metabolic compounds (eg, glucose) were also measured. No significant changes were found in APPs after weight loss (P > 0.3), but significant increases in plasma adiponectin (P = 0.021) and IGF-1 (P = 0.036) were seen, whereas insulin (P < 0.001) and homeostasis model assessment (P = 0.005) decreased significantly. Plasma concentrations before weight loss of PON-1 (P = 0.004), adiponectin (P = 0.02), and IGF-1 (P = 0.048) were less in cats that failed to complete weight loss than cats that were successful, whereas glucose concentration was greater. Finally, multivariable linear regression analysis showed that lean tissue loss during weight management was associated with percentage weight loss (greater weight loss, greater lean tissue loss; R = 0.71, P < 0.001) and plasma adiponectin concentration before weight loss (lesser adiponectin, more lean tissue loss; R = -0.52, P = 0.023). In conclusion, various metabolic abnormalities occur in feline obesity, and these can be linked to outcomes of weight-loss programs. The changes that occur with weight loss suggest an improved metabolic status.

Quality of life is reduced in obese dogs but improves after successful weight loss.

Obesity is thought to affect quality of life, but limited objective data exist to support this supposition. The current study aim was to use a questionnaire to determine health-related quality of life (HRQOL) both before and after weight loss, in obese client-owned dogs. Fifty obese dogs were included, and represented a variety of breeds and genders. Prior to weight loss, owners were asked to complete a validated standardised questionnaire to determine HRQOL. Thirty of the dogs successfully completed their weight loss programme and reached target, and owners then completed a follow-up questionnaire. The completed questionnaire responses were transformed to scores corresponding to each of four factors (vitality, emotional disturbance, anxiety and pain), and scored on a scale of 0-6. Changes in the scores were used to explore the sensitivity of the questionnaire, and scores were correlated with responses to direct questions about quality of life and pain, as well as weight loss. Dogs that failed to complete their weight loss programme had lower vitality and higher emotional disturbance scores than those successfully losing weight (P=0.03 for both). In the 30 dogs that completed, weight loss led to an increased vitality score (P<0.001), and decreased scores for both emotional disturbance (P<0.001) and pain (P<0.001). However, there was no change in anxiety (P=0.09). The change in vitality score was positively associated with percentage weight loss (r(P)=0.43, P=0.02) and percentage body fat loss (r(P)=0.39, P=0.03). These results indicate demonstrable improvement in HRQOL for obese dogs that successfully lose weight.

Imprecision when using measuring cups to weigh out extruded dry kibbled food.

Many pet cats and dogs are fed dry extruded kibbled food by measuring cup, yet the precision and accuracy of this feeding strategy is not known. Over 12 studies, we assessed precision and accuracy of weighing out food portions, of various dry kibbled foods, by measuring cup. Poor precision was noted in all studies, with intra- and inter-subject coefficients of variation ranging from 2 to 13% and 2 to 28% respectively. Variable accuracy was also noted, which ranged from an 18% under-estimate to an 80% over-estimate in portion size. No specific factors were associated with imprecision, but the degree of inaccuracy was negatively associated with portion size (R = -0.67, p = 0.022), and positively associated with the number of subjects participating in the study (R = 0.60, p = 0.048). This is the first study to document imprecision and inaccuracy of using measuring cups to estimate portions of extruded dry kibbled food. Over time, such errors could contribute to insidious weight gain in companion animals, potentially contributing to the development of obesity. Imprecision in measuring food portions could also contribute to failure of weight management programmes for obese animals.

Improvement in insulin resistance and reduction in plasma inflammatory adipokines after weight loss in obese dogs.

Obesity is now a major disease of dogs, predisposing to numerous disorders including diabetes mellitus. Adipocytes are active endocrine cells, and human obesity is characterized by derangements in inflammatory adipokine production. However, it is unclear as to whether similar changes occur in dogs. The purpose of the current study was to assess insulin sensitivity and inflammatory adipokine profiles in dogs with naturally occurring obesity and to investigate the effect of subsequent weight loss. Twenty-six overweight dogs were studied, representing a range of breeds and both sexes. All dogs underwent a weight loss program involving diet and exercise. Body fat mass was measured by dual-energy x-ray absorptiometry; plasma concentrations of insulin, glucose, and a panel of inflammatory adipokines (including acute-phase proteins, cytokines, and chemokines) were also analyzed. Body fat mass before weight loss was positively correlated with both plasma insulin concentrations (Kendall tau=0.30, P=0.044) and insulin:glucose ratio (Kendall tau=0.36, P=0.022), and both decreased after weight loss (P=0.0037 and 0.0063, respectively). Weight loss also led to notable decreases in plasma tumor necrosis factor-alpha (TNF-alpha), haptoglobin, and C-reactive protein concentrations (P<0.05 for all), suggesting improvement of a subclinical inflammatory state associated with obesity. This study has demonstrated that in obese dogs, insulin resistance correlates with degree of adiposity, and weight loss improves insulin sensitivity. Concurrent decreases in TNF-alpha and adipose tissue mass suggest that in dogs, as in humans, this adipokine may be implicated in the insulin resistance of obesity.

Use of starting condition score to estimate changes in body weight and composition during weight loss in obese dogs.

Prior to starting a weight loss programme, target weight (TW) is often estimated, using starting body condition score (BCS). The current study assessed how well such estimates perform in clinical practice. Information on body weight, BCS and body composition was assessed before and after weight loss in 28 obese, client-owned dogs. Median decrease in starting weight per BCS unit was 10% (5-15%), with no significant difference between dogs losing moderate (1-2 BCS points) or marked (3-4 BCS points) amounts of weight (P=0.627). Mean decrease in body fat per BCS unit change was 5% (3-9%). A model based on a change of 10% of starting weight per unit of BCS above ideal (5/9) most closely estimated actual TW, but marked variability was seen. Therefore, although such calculations may provide a guide to final TW in obese dogs, they can either over- or under-estimate the appropriate end point of weight loss.

Successful resolution of dermatophyte mycetoma following terbinafine treatment in two cats.

Microsporum canis sensitive to itraconazole and terbinafine was isolated from two cats presented with generalized dermatophytosis and dermatophyte mycetoma. Itraconazole therapy was withdrawn through lack of efficacy in one cat (a Persian) and unacceptable adverse effects in the other (a Maine Coon). Both cats achieved clinical and mycological cure after 12-14 weeks therapy with 26-31 mg kg(-1) terbinafine every 24 h per os (PO). Clinical signs in the Maine Coon resolved completely after 7 weeks treatment. Four weeks of therapy with additional weekly washes with a 2% chlorhexidine/2% miconazole shampoo following clipping produced a 98% reduction in the Persian cat's mycetoma, which was then surgically excised. Recurrent generalized dermatophytosis in the Persian cat has been managed with pulse therapy with 26 mg kg(-1) terbinafine every 24 h PO for 1 week in every month. No underlying conditions predisposing to dermatophytosis were found in either cat despite extensive investigation. Terbinafine administration was associated with mild to moderate lethargy in the Persian cat, but no other adverse effects or changes in blood parameters were seen. To the best of the authors' knowledge this is the first report of a dermatophyte mycetoma in a Maine Coon and of successful resolution of this condition in cats following terbinafine therapy.