Obesity and… managing medical issues in the obese patient

Presented by Sheri Ross, BSc, DVM, PhD, Dipl. ACVIM (IM), Dipl. ACVNU (founding member), Sarah Wilson, BScH, DVM, Dipl. ACVIM (nutrition)

Continuing education questionnaire

CE credit: 1

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Questions

1. According to a 2017 survey, what percentage of dogs and cats living in the United States are considered overweight or obese? *

26% of dogs and 30% of cats

38% of dogs and 40% of cats

56% of dogs and 60% of cats

66% of dogs and 70% of cats

2. What is the normal (healthy) fat composition for an adult (6-year-old) dog? *

5%–10% fat

16%–25% fat

26%–35% fat

36%–45% fat

3. Shadow is a 6-year-old mixed breed dog diagnosed with IRIS stage II CKD. She is not hypertensive and has a UPC of 4. She is also obese with a body fat index of at least 50. Which of the following would be the best nutritional intervention? *

Transition her to a therapeutic renal diet and feed her at 0.5 x RER to ensure weight loss

Leave her on her regular diet, but reduce her caloric intake by 50%

Transition her to a therapeutic renal diet and feed her at 1.4 x RER, as she will lose weight because of her kidney disease eventually

Calculate her caloric needs for gradual weight loss of no more than 0.5% BW per week and choose a diet that will meet her protein and other nutritional requirements given the amount she will be receiving

4. According to the consensus statements, the following diagnostics are recommended for ALL patients with suspected proteinuric renal disease EXCEPT: *

Renal biopsy

Complete history and physical exam

CBC, serum chemistry panel, urinalysis, UPC and urine culture

Infections disease testing based on endemic area and travel history

5. According to the consensus statements, “standard therapy” for proteinuria includes all of the following EXCEPT: *

Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers

Feeding a prescription “renal diet”

Anticoagulation, if indicated

Immunosuppressive drugs

6. You are managing a newly diagnosed diabetic cat with insulin therapy. His BCS is 9+/9 and you estimate his body fat index to be roughly 60%. Which of the following nutritional recommendations is likely to be the most beneficial for the cat? *

Continue feeding his current diet ad lib, as we do not want to change too many things at once

Restrict his feeding to once daily to provide some regularity and facilitate insulin injections

Consider a diet that has a lower carbohydrate content and control his daily caloric intake to produce a gradual weight loss of no more than 0.5% BW per week

Change to a commercial feline “diabetic diet” and feed ad lib until the diabetes is controlled and worry about weight loss later.

7. Oscar is an 8 yr MN DSH previously diagnosed as obese and diabetic. He was treated with insulin and a weight loss plan. Today, Oscar’s BCS is 5/9 and BFI is 24% (down from 65% last year). What is likely causing Oscar’s episodic weakness? *

The insulin is no longer effective

Oscar has decided to fake an illness to convince his owners to give him tuna

Oscar has lost so much weight that he is having episodes of muscle weakness from malnutrition

An appropriate diet and healthy body weight has caused remission of his diabetes and he is no longer insulin dependent.

8. In humans with cancer, obesity has been associated with which of the following? *

Tumour initiation

Decreased response to treatment

Higher rate of recurrence

All of the above

9. Which of the following are some of the important nutrients to consider in patients with cancer? *

Protein, L-carnitine and manganese

L-Carnitine, overall fat content and omega-3 fatty acids

Overall caloric intake, L-carnitine and high-quality protein

Omega-3 fatty acids, taurine and potassium

10. True or False. Patients with obesity and a comorbid disease should always be transitioned to a therapeutic weight loss diet regardless of the comorbidity, and encouraged to lose weight at a typical weight loss rate of 1%–2% body weight per week. *

True

False