Insect Repellent, Antiviral Drug Detected in Jerky Pet Treats for Dogs

Chicken jerky treats consumed by dogs that became sick over the past few month have now been found to be tainted by the insect repellent N,N-diethyl-meta-toluamide, better known as DEET, as well as the antiviral drug amantadine.

This is according to a veterinary pathologist leading an independent probe of the ongoing pet treat mystery.  For more information, click this link to read the article by the Veterinary Information Network News Service.

What's the Best Insulin for Treating Dogs with Diabetes Mellitus?

I am writing you regarding my 11-year old male Weimaraner, Duke. He has always been in good health but over this past week he has had 2 ”accidents” where he has urinated in the bed. He has also been drinking a lot more water than usual and urinating more too.

I  took him to the vet because I had a feeling he might be diabetic. My veterinarian confirmed that it was indeed diabetes mellitus and started him on 10 units of NPH, once after breakfast and once after dinner.  He has improved since starting the insulin, but remains quite thirsty and continues to urinate excessively.

Now I know that this will not give very good control alone because NPH is only a long-acting insulin. I am a Type 1 diabetic, diagnosed when I was 12 years old, so I have quite a bit of experience dealing with this disease. I want my poor puppy to be as controlled as possible so he does not feel like I do when my sugars are out of control— lethargic, nausea, headaches, unquenchable thirst, urinating all the time, and just plain crappy! Not to mention the stress this puts on the on the rest of the body.

If dogs are anything like people, I believe that Duke needs an insulin mixture that will bring his blood glucose down to normal and keep it leveled out. I have been giving him the rapid-acting insulin analog Humalog (insulin lispro) along with the NPH and that seems to be working really well, with marked improvement in his thirst and urination.  The only problem is that he needs 4-6 injections of Humalog each day. I was hoping you have had experience with something that would give him the same control as Humalog but with less injections daily.

In the past, I have used short-acting Regular insulin (before Humalog was invented) but I do not remember how the dosing went. I do have much better control with the Humalog but I am also on an insulin pump, so NPH insulin is no longer necessary.

Any help you can give to allow my dog Duke better control long term without so many injections would be greatly appreciated.

My Response:

In dogs, veterinarians commonly start with an intermediate-acting insulin (NPH or Vetsulin) twice a day (1,2). In some dogs, I find it necessary to add a short-acting insulin to the longer-acting insulin preparation, but many dogs can achieve adequate glucose control without giving more than 2 injections per day.

Insulin of choice for canine diabetics
In my opinion, the insulin of choice for most dogs is Vetsulin (porcine insulin zinc suspension; Merck Animal Health) (3). The main advantage of Vetsulin (known as Caninsulin outside the USA (4), is that it is actually composed of both short- and long-acting insulin components (see Figure below, showing the duel peaks of activity) (5,6). So giving Vetsulin is like administrating NPH together with a second, short-acting insulin preparation, like you are doing now.  However, Vetsulin works better than NPH for most dogs because it has a longer duration of action than NPH.

Timing of meals and insulin injection
The short-acting amorphous fraction of the Vetsulin, which composes 35% of the insulin activity, acts like regular insulin or Humulog, mainly to control the rise in blood glucose after each meal (6).  To help prevent severe rises in glucose after meals, however, it is also important to give the insulin before meals, instead of after the food is ingested, as you are doing now. This protocol will allow the short-acting insulin to be absorbed into the blood stream and ready to act to lower the blood sugar as soon as the food is absorbed from the gastrointestinal tract (7).

The only time I don't do this insulin-feeding protocol is in dogs that don't always eat their meal well; but even in those dogs, I never wait long after the meal is finished to give the insulin. Instead, I always give the insulin injection as soon as possible, once the dog has eaten a sufficient amount of food.

Vetsulin (porcine insulin zinc suspension), with it's 2 peaks of insulin activity

References:

1. Nelson RW. Canine diabetes mellitus In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. Seventh Edition ed. St. Louis: Saunders Elsevier, 2010;1449-1474.
2. Davison LJ. Canine diabetes mellitus In: Mooney CT, Peterson ME, eds. BSAVA Manual of Canine and Feline Endocrinology. Fourth ed. Quedgeley, Gloucester: British Small Animal Veterinary Association, 2012;116-132.
3. Vetsulin website. www.vetsulin.com 
4. Caninsulin website. www.caninsulin.com
5. Monroe WE, Laxton D, Fallin EA, et al. Efficacy and safety of a purified porcine insulin zinc suspension for managing diabetes mellitus in dogs. J Vet Intern Med 2005;19:675-682.
6. Fleeman LM, Rand JS, Morton JM. Pharmacokinetics and pharmacodynamics of porcine insulin zinc suspension in eight diabetic dogs. Vet Rec 2009;164:232-237.
7. Cobry E, McFann K, Messer L, et al. Timing of meal insulin boluses to achieve optimal postprandial glycemic control in patients with type 1 diabetes. Diabetes Technol Ther 2010;12:173-177. 

What's the Expected Time for Signs of Feline Hyperthyroidism to Resolve after Treatment?

My 16-year old cat was recently treated with radioiodine (I-131) for his severe hyperthyroidism. How long after radioiodine treatment will the thyroid values normalize and the symptoms of the hyperactive thyroid begin to resolve so he feels better? 

My cat lost about half of his body weight, much of it in muscle mass. Will his wasted muscles ever return to normal? If so, when can I expect to see improvement?

My Response: 

You have asked two good questions, which, on the surface seem simple enough to answer. The answers to "how long for clinical signs to resolve" however, depend on a number of factors. I'll do my best to explain why it's not possible for me to give you the definitive answers you want.

How long does it take for serum thyroid hormone levels to normalize after I-131?
Depending on the dosing protocol used, about 90% of cats will have serum thyroid hormone concentrations (e.g., T4 and T3) within reference range limits by 30 days after I-131 treatment. Most of the remaining cats will show a nice drop in T4 and T3 levels when rechecked in a month, but it will take longer to for their thyroid hormone concentrations to completely normalize.

In general, the full extent of the radioiodine treatment will be evident by 3 months after treatment, although a few cats continue to show even more (minor) improvement when rechecked at 4 to 6 months.

As the thyroid values normalize, the clinical signs we see also gradually resolve. Some signs, such as nervousness or rapid heart rate, generally resolve fairly quickly, whereas other signs, such as marked weight loss and muscle wasting, obviously take much longer.

How fast do we want the serum thyroid values to fall after radioiodine treatment?
My goal in treating hyperthyroid cats with radioiodine is to gradually normalize the high serum thyroid hormone concentrations— not lower the values too quickly. I'd rather that the thyroid values fall slowly over the first month after treatment, allowing the rest of the body to gradually get used to being euthyroid once again. This is especially true in cats with concurrent kidney disease, when a drastic fall in thyroid values can aggravate the serum kidney values and can even lead to severe renal failure.

To achieve this gradual fall in the high serum thyroid hormone levels, I administer the smallest dose necessary to cure the hyperthyroidism. By giving individualized, lower doses of radioiodine, we can also reduce the incidence of post-treatment hypothyroidism (underactive thyroid condition) in these cats.

How often does the radioiodine fail to cure the hyperthyroidism?
About 5% of cats that I treat will remain slightly hyperthyroid at the 3-month follow-up period. Many treatment facilities will claim a higher rate of cure (98-100%) than I do, which is made possible by administering higher doses of radioiodine to their cats. In addition to decreasing the incidence of persistent hyperthyroidism, the use of higher radioiodine doses will also hasten the rate of decline in the serum thyroid hormone concentrations.

So why not use this high-dose I-131 protocol instead of my lower-dose approach? Simple — the downside of administering higher radioiodine doses is that this method will lead to a higher rate of iatrogenic hypothyroidism as both the thyroid tumor, as well as most normal thyroid tissue, are irradiated and destroyed (1,2). As I've previously discussed (see my post, Estimating the Radioiodine Dose to Administer to Cats with Hyperthyroidism), more that 30% of cats will become hypothyroid using the standard high-dose treatment protocol, but this incidence could in fact be much higher, possibly up to 75%.

Diagnosing iatrogenic hypothyroidism
To monitor for iatrogenic hypothyroidism, we routinely run a serum thyroid panel (i.e., total T4, T3, free T4, and TSH) at 1 and 3 months after treatment (2,3). Most facilities recommend monitoring just the total T4 concentration, but this is not adequate for monitoring since many hypothyroid cats will maintain a low-normal total T4 value, despite being hypothyroid.  Based on our studies, it's becoming increasing clear that feline hypothyroidism can only be diagnosed by finding low to low-normal T4 and T3 values in conjunction with high TSH values.

Restoring lost body weight and muscle mass
Once euthyroidism is reestablished, most cats will gain weight within a few weeks (certainly by 2-3 months). If marked muscle wasting has occurred, it may not be possible to completely regain the lost muscle. Remember that it will help to feed a diet that's higher in protein (40-50% of calories), higher in fat (40-50% of calories), and relatively low in carbs (less than 15% of calories) (4). For more information, check out my post on The Best Diet to Feed Hyperthyroid Cats.

References:

1. Peterson ME, Broome MR. Radioiodine for feline hyperthyroidism In: Bonagura JD, Twedt DC, eds. Kirk's Current Veterinary Therapy, Volume XV. Philadelphia: Saunders Elsevier, 2014.
2. Peterson ME. Feline focus: Diagnostic testing for feline thyroid disease: hypothyroidism. Compend Contin Educ Vet 2013;35:E4. 
3. Peterson ME. Diagnosis and management of iatrogenic hypothyroidism In: Little SE, ed. August's Consultations in Feline Internal Medicine: Elsevier, 2014;in press.
4. Peterson ME. Nutritional management of endocrine disease in cats. Proceedings of the Royal Canin Feline Medicine Symposium 2013;23-28.

Related Blog Posts:

• Peterson ME. How Does Radioiodine Really Work to Treat Hyperthyroidism? Insights into Veterinary Endocrinology blog.  July 12, 2012.
• Peterson MEL Estimating the Radioiodine Dose to Administer to Cats with Hyperthyroidism. Animal Endocrine Clinic blog. April 30, 2013.
• Peterson ME. Success Rates for Radioiodine Treatment in Hyperthyroid Cats. Animal Endocrine Clinic blog. May 24, 2013.
• Peterson ME. The Best Diet to Feed Hyperthyroid Cats. Insights into Veterinary Endocrinology blog. September 13, 2011

Podcast: Increasing Rates of Obesity in Our Cats and Dogs

We love our pets. But sometimes, when it comes to rewarding them with treats and food, we might love them a little too much. As a result, our pets are increasingly overweight and obese.

To help quantify just how serious this issue has become, the Association for Pet Obesity Prevention (for which Dr. Peterson serves as a board member) conducts annual surveys on obesity in U.S. pets. Just last week, the group released its 6th annual survey.

In the latest AVMA Animal Tracks podcast, Dr. Ernie Ward, founder of APOP, discusses this year's results. To here the podcast, click this link.

For more information about the 2012 National Pet Obesity survey results or the Association for Pet Obesity Prevention in general, please visit their website at www.petobesityprevention.com.

Muscle Wasting in a Hyperthyroid Cat Fed Hill's y/d

I have read your blog posts concening the Hill's y/d diet with much interest (1-5). We have been feeding our 13-year-old female cat the Hill's y/d diet for 6 months now. The high serum thyroid values have come down into the high-normal range and her weight loss has stopped. However, she doesn't look like the same cat as she used to be, and we have noticed her getting smaller and more bony. She eats the y/d, but not with the same gusto as she used to eat when we fed her regular OTC canned foods.

Is this the muscle wasting you talk about in your blogs? Should we change her treatment and put her on medication in order for her to have a more balanced diet?

Although she is not very old, the procedures listed to "cure" hyperthyroidism look like they may be risky. We don't want our cat to undergo anesthesia or have surgery. Is the radioactive treatment dangerous to our cat's health? What does the radioiodine procedure involve? Is it expensive? Does this procedure make it dangerous to handle the cat litter for awhile?

We want my cat to live a long and happy life, but it looks like she won't be able to keep going very long if we keep her on this diet! Thanks for your advice.

My Response:

Muscle wasting and protein needs in older cats
I agree that it is likely that your cat looks "smaller" because of the loss of muscle mass that can occur in  hyperthyroid cats if not fed enough protein (6-9). Like I discuss in my blog posts, Hill's y/d is not a high protein diet, containing less than 28% of calories as protein (1). In contrast, cats in the wild generally eat between 50-60% of their daily calories as protein.

A recent paper proves that cats, as obligate carnivores, require over 5 grams of protein each day to maintain muscle mass (10). Hyperthyroid cats would be expected to need even more protein, since hyperthyroidism is a catabolic state and it's well known that we see muscle breakdown and muscle loss with this disease (2,6,7). Putting that amount of protein into perspective, that means that we should be feed our cats a diet that contains at least 40% of their calories as protein to restore or regain lost muscle mass, an amount much greater than that contained in the y/d diet.

Best treatment for a young hyperthyroid cat without concurrent disease
In my opinion, we should try to remove or destroy the thyroid tumor in any cat that is relatively young and in good health otherwise. At 13-years of age, your cat certainly is not very old (only about 55-60 in human years). By choosing either surgery or radioiodine, we will be able to cure the thyroid disease and do not have to feed an iodine deficient diet (y/d) or use life-long, twice daily medication (9,11).

In most cats, leaving the thyroid tumor allows it to continue to grow larger and larger, and in some cats, the benign tumor can transpose into a malignant carcinoma (12). Radiodine is generally considered to be the treatment of choice. Compared to surgery, no anesthesia is needed, and we don't have to worry about parathyroid damage (the 4 little glands around the thyroid that control calcium) or possible hypocalcemia. For more information about the pros and cons of radioiodine, see my hospital website (www.animalendocrine.com). I also have a FAQ section on the website that should answer all of your questions about this treatment.

If done properly, radioiodine is not at all risky (12). At our facility, most cats only stay with us for 3-5 days. The doses of radioiodine we use are actually quite small in most cats, so their whole body radiation levels are not very high and no side effects are expected.  To make it easier for you to be separated from your cat, we have even installed webcams within each of their condos so you can check-in whenever you wish.

Like you, I too want all cats to live a long and heathy life. In cats with hyperthyroidism, I believe this includes curing the disease so we can focus on proper nutrition (6,7) and environmental enrichment. By not giving life-long medication, this also reduces the cat's level of stress, which we do see in some cats that have to be chronically medicated. And what cat really wants to eat a single type of food every day for the rest of their lives?

References:

1. Peterson ME. Is Hill's y/d a nutritious diet for hyperthyroid cats? Insights into Veterinary Endocrinology. September 28, 2011. 
2. Peterson ME. Optimal protein requirements for older cats and cats with hyperthyroidism. Insights into Veterinary Endocrinology. November 7, 2011. 
3. Peterson ME. Is the protein content of Hill's y/d too low to restore and maintain muscle mass in cats with hyperthyroidism? Insights into Veterinary Endocrinology. November 10, 2011. 
4. Peterson ME. Can increasing the amount of fat or carbohydrate in a cat's diet compensate for low protein intake? Insights into Veterinary Endocrinology. December 22, 2011. 
5. Peterson ME. Is it feasible for older cats to ingest the optimal amounts of protein they need each day? Insights into Veterinary Endocrinology. December 14, 2011. 
6. Peterson ME. Nutritional management of endocrine disease in cats. Proceedings of the Royal Canin Feline Medicine Symposium 2013; 23-28 2013;23-28.
7. Peterson ME. The best diet to feed hyperthyroid cats. Insights into Veterinary Endocrinology. September 13, 2011. 
8. Sparkes AH. Feeding old cats— An update on new nutritional therapies. Topics in Companion Animal Medicine 2011;26:37-42.
9. Baral R, Peterson ME: Thyroid gland disorders, In: Little, S.E. (ed), The Cat: Clinical Medicine and Management. Philadelphia, Elsevier Saunders. pp. 571-592, 2012.
10. Laflamme DP, Hannah SS. Discrepancy between use of lean body mass or nitrogen balance to determine protein requirements for adult cats. J Fel Med Surg 2013; in press. 
11. Peterson ME, Broome MR. Radioiodine for hyperthyroidism. In: Bonagura JD, Twedt DC (eds): Current Veterinary Therapy V. Philadelphia, Saunders Elsevier, 2013; in press.
12. Peterson ME, Broome MR. Hyperthyroid cats on long-term medical treatment show a progressive increase in the prevalence of large thyroid tumors, intrathoracic thyroid masses, and suspected thyroid carcinoma. J Vet Intern Med 2012;26:1523.

Should Hill's y/d Diet Ever Be Used to Manage Cats with Hyperthyroidism?

Hyperthyroid cat with an allergic reaction (facial pruitus) secondary to methimazole

We are unlikely enough to have not one... but two cats with hyperthyroidism. One has responded well to treatment with methimazole, with normalization of the serum T4 value, while the other cat had a severe allergic reaction (facial pruitus) so we had to stop the medication. Because of her age and how ravaged she was by the allergic reaction, we didn't want to do radiation or surgery.

My veterinarians suggested that we could try Hills' y/d diet, since no other good options were available. Since we had no other options available, we felt that we had nothing to lose.  Luckily, our cat will eat the diet. Slowly, she has improved and is doing fairly well.

Who knows if this food will be good for her long term (I take your comments seriously about what cats truly need in their diet), but she's almost 16-years old and has enjoyed a good life. Considering our situation, trying the diet was worth a shot, and it has lowered the serum T4 value to normal.

Now I'm feeling guilty — should I continue the y/d or should I rethink my decision not to use the radioiodine?

My Response:

I consider the feeding of Hill's y/d diet to be a fourth-line of treatment for hyperthyroidism; I'd recommend this treatment only if none of the 3 other options (i.e., radioiodine, surgical thyroidectomy, or methimazole) can be used (1-3).

If a hyperthyroid cat will eat this ultra-low iodine food (and not eat anything else), the y/d certainly will lower the serum thyroid hormone concentrations (4). Remember that iodine is an essential nutrient and is needed to make thyroid hormone; with this diet, we are inducing an iodine deficient state so the cat's thyroid tumor will not be able to continue to produce large amounts of thyroid hormone on this diet (5).

However, like methimazole, feeding an ultra-low iodine diet can not cure the primary cause of hyperthyroidism (ie, the thyroid tumor). The thyroid tumor, which is almost always benign at time of diagnosis) will continue to grow with time (5,6). In some cats, this benign tumor can also transform to a more malignant carcinoma after a few months to years. So whenever possible,  I believe it's always better to remove the thyroid tumor with surgery or ablate it with radioiodine —in that way, we are curing rather than prolonging the disease and not allowing the thyroid tumor to continue to grow.

Now, if you consider 16 year's of age too old for definite treatment, then y/d can certainly be fed. For a geriatric cat, I don't consider 15 or 16 years of age too old for definitive treatment unless other concurrent problems are present that are known to shorten their lives. Remember that old age itself isn't a disease, and I see many senior cats that are still doing well at 18 to 20 years of age.

The main advantage of the methimazole over the y/d is that we can control what the cat is fed (remember that cats managed with y/d can ONLY eat that diet).  The best diet for a hyperthyroid cat or any senior cat for that matter is one that is lower in carbohydrates (<15% of calories) and higher in protein (>35-40% of calories) (7).  Senior cats don't absorb protein as well as younger cats and will develop weight loss and muscle wasting as they age (8-11). Other than exercise (and good luck with getting most cats to enter a weight lifting regime), the best way we know to maintain muscle mass is to feed a higher protein diet.

When we look at the dietary composition of Hill's y/d, it's way too high in carbs (>23% of calories), and much too low in protein (<28% of calories). In addition, the protein that's contained in the dry y/d is all plant protein, which isn't as good as animal protein is for cats — when was the last time you heard of a feral cat that was a vegetarian?

Obviously, in your cat, we can never use methimazole again because of the severe allergic reaction that occurred.  So, should you continue the y/d for your cat?  That's a decision that you will have to make— remember that any treatment, including the y/d, is better than no treatment at all.

But I like to treat the whole animal, however, and that involves more than just giving pills, feeding an iodine-deficient diet, or even giving an injection of radioiodine. For me, that involves proper geriatric nutrition, supplements in some cats, and finally, environmental stimulation to help enrich their lives (1-3, 7).

References: 

1. Mooney CT, Peterson ME. Feline hyperthyroidism In: Mooney CT, Peterson ME, eds. BSAVA Manual of Canine and Feline Endocrinology. Fourth ed. Quedgeley, Gloucester: British Small Animal Veterinary Association. 2012;92-110.
2. Baral RM, Peterson ME. Thyroid gland disorders In: Little SE, ed. The Cat: Clinical Medicine and Management. St. Louis: Elsevier Saunders, 2012;571-592.
3. Peterson ME. Hyperthyroidism in cats In: Rand JS, Behrend E, Gunn-Moore D, et al., eds. Clinical Endocrinology of Companion Animals. Ames, Iowa Wiley-Blackwell, 2013;295-310.
4. Yu S, Wedekind KJ, Burris PA, et al. Controlled level of dietary iodine normalizes serum total thyroxine in cats with naturally occurring hyperthyroidism [abstract]. J Vet Intern Med 2011;25:683-684.
5. Peterson M. Hyperthyroidism in cats: What's causing this epidemic of thyroid disease and can we prevent it? J Feline Med Surg 2012;14:804-818.
6. Peterson ME, Broome MR. Hyperthyroid cats on long-term medical treatment show a progressive increase in the prevalence of large thyroid tumors, intrathoracic thyroid masses, and suspected thyroid carcinoma. J Vet Intern Med 2012;26:1523.
7. Peterson ME. Nutritional management of endocrine disease in cats. Proceedings of the Royal Canin Feline Medicine Symposium 2013; 23-28 2013;23-28.
8. Teshima E, Brunetto MA, Vasconcellos RS, et al. Nutrient digestibility, but not mineral absorption, is age-dependent in cats. J Anim Physiol Anim Nutr (Berl) 2010;94:e251-258. 
9. Sparkes AH. Feeding old cats--an update on new nutritional therapies. Top Companion Anim Med 2011;26:37-42. 
10. Perez-Camargo G. Feline decline in key physiological reserves implications for mortality. Proceedings of the Nestlé Purina Companion Animal Nutrition Summit: Focus on Gerontology 2010;6-13. 
11. Freeman LM. Cachexia and sarcopenia: emerging syndromes of importance in dogs and cats. J Vet Intern Med 2012;26:3-17.

My Related Posts on Hill's y/d Diet (Insights into Veterinary Endocrinology Blog)

Hyperthyroidism in Cats: Past and Upcoming Topics

As you know, if you have been following this blog, I've spent much of the last few months writing about issue of hyperthyroidism, the most common endocrine disorder of the cat.

Unfortunately, I got sidetracked and have not yet finished discussing all of the treatment options that we have for management of this common problem. However, I do plan to finish up this series of topics over the upcoming weeks.

But before I move on to the topics of treatment of this common feline condition, I thought I'd post links to the topics I've covered thus far:

1. Do All Hyperthyroid Cats Have a Thyroid Tumor? Is It Thyroid Cancer?
2. Why Has Hyperthyroidism in Cats Reached Epidemic Levels?
3. Top 10 Signs of Hyperthyroidism in Cats
4. Top 12 Physical Exam Findings in Cats with Hyperthyroidism
5. Hypertension (High Blood Pressure): A Common Problem in Cats
6. Diagnosing Hyperthyroidism in Cats: Routine Testing Procedures
7. Diagnosis of Hyperthyroidism in Cats: Serum T4 Concentrations
8. Diagnosis of Hyperthyroidism in Cats: Serum T3 Concentrations
9. Diagnosis of Hyperthyroidism in Cats: Serum Free T4 Concentrations
10. Diagnosis of Hyperthyroidism in Cats: Serum Free T4 (Part 2)
11. Diagnosis of Hyperthyroidism in Cats: Serum Free T3 Concentrations
12. Diagnosis of Hyperthyroidism in Cats: Serum TSH Concentrations
13. Diagnosis of Hyperthyroidism: T3 Suppression Test
14. Diagnosis of Hyperthyroidism: TRH Stimulation Test
15. Diagnosis of Hyperthyroidism: Thyroid Scintigraphy
16. Treatment Options and Considerations for Hyperthyroid Cats
17. Do Hyperthyroid Cats Ever Go Into Spontaneous Remission? 
18. Daily Water and Fluid Requirements and Needs for Hyperthyroid Cats
19. Diet and Nutritional Management of Hyperthyroid Cats
20. Treating Cats with Hyperthyroidism: Antithyroid Drugs

I'll be posting my next post on feline hyperthyroidism (entited, Antithyroid Drug Treatment for Hyperthyroidism: Brand Name, Generic, or Compounded Drug?) within the next couple of days; then I'll continue with treatment issues, with about a post once a week.

How to Feed Cats: Examining the Nutrition of Feral Cats

Paper Review: The Nutrition of Feral Cats 

Estimation of the dietary nutrient profile of free-roaming feral cats: possible implications for nutrition of domestic cats. 

British Journal of Nutrition 2011;106 Suppl 1:S35-48. 

by E.A. Plantinga, G. Bosch, and W.H. Hendriks 

Abstract
Cats are strict carnivores and in the wild rely on a diet solely based on animal tissues to meet their specific and unique nutritional requirements. Although the feeding ecology of cats in the wild has been well documented in the literature, there is no information on the precise nutrient profile to which the cat's metabolism has adapted.

The present study aimed to derive the dietary nutrient profile of free-living cats. Studies reporting the feeding habits of cats in the wild were reviewed and data on the nutrient composition of the consumed prey items was obtained from the literature.

Fifty-five studies reported feeding strategy data of cats in the wild. After specific exclusion criteria, twenty-seven studies were used to derive thirty individual dietary nutrient profiles. The results show that feral cats are obligatory carnivores, with their daily energy intake from crude protein being 52%, from crude fat 46% and from N-free extract (i.e., carbohydrates) only 2%. Minerals and trace elements are consumed in relatively high concentrations compared with recommended allowances determined using empirical methods.

The calculated nutrient profile may be considered the nutrient intake to which the cat's metabolic system has adapted. The present study provides insight into the nutritive, as well as possible non-nutritive aspects of a natural diet of whole prey for cats and provides novel ways to further improve feline diets to increase health and longevity.

My Comments 
In this excellent study (1), the researchers reviewed 27 published studies reporting the feeding habits of feral cats and obtained data on the nutrient composition of the cats’ prey. The results showed that feral cats are obligatory carnivores with a diet high in protein (52% of daily energy) and fat (46% of daily energy) content, but low in carbohydrates (2% of daily energy). The results of this study should be expected since it has long been recognized that cats are strict carnivores, with a high dietary need for protein and fat but no dietary need for carbohydrates (2-5).

The typical prey diet of cats is low in carbohydrate (<10% of metabolizable energy (ME) (6-9). However, most commercially available cat foods are moderate to high in carbohydrate content (> 25 – 55 % ME), partly because of the difficulty in formulating extruded, dry diets that are low in carbohydrate. But higher carbohydrates are also used in cat food diets because cereal is a relatively inexpensive ingredient, and there is demand for lower-cost diets in the pet food market.

I believe strongly that many of the present-day diseases of the domestic cat are related to an "unnatural" diet, one too high in carbohydrates and too low in protein and fat. I believe we should be feeding our cats closer to what they would be eating in the wild, at least if they do not have special nutritional needs because of diseases such as kidney disease. Future research should focus on the value of feeding a natural diet of whole prey as a means of enhancing both feline health and longevity.

The authors should be commended for doing this excellent study and publishing the results. Hopefully, the pet food industry will pay attention.

References:

1. Plantinga EA, Bosch G, Hendriks WH. Estimation of the dietary nutrient profile of free-roaming feral cats: possible implications for nutrition of domestic cats. British Journal of Nutrition 2011;106 (Suppl 1):S35-48.
2. MacDonald ML, Rogers QR, Morris JG. Nutrition of the domestic cat, a mammalian carnivore. Annual Review of Nutrition 1984;4:521-562.
3. Zoran DL. The carnivore connection to nutrition in cats. Journal of the American Veterinary Medical Association 2002;221:1559-1567. 
4. Morris JG. Idiosyncratic nutrient requirements of cats appear to be diet-induced evolutionary adaptations. Nutrition Research Reviews 2002;15:153-168. 
5. Bradshaw JWS. The evolutionary basis for the feeding behavior of domestic dogs (Canis familiaris) and cats (Felis catus). Journal of Nutrition 2006;136:1927S–1931S.
6. Myrcha A, Pinowski J. Weights, body composition and caloric value of post-juvenile molting European tree sparrows. Condor 1970;72:175–178.
7. Vondruska JF. The effect of a rat carcass diet on the urinary pH of the cat. Companion Animal Practice 1987;1:5-9.
8. Crissey SD, Slifka KA, Lintzenich BA. Whole body cholesterol, fat, and fatty acid concentrations of mice (Mus domesticus) used as a food source. Journal of Zoo and Wildlife Medicine 1999;30:222-227.
9. Eisert R. Hypercarnivory and the brain: protein requirements of cats reconsidered. Journal of Comparative Physiology B, 2011;181:1-17.

Can a New Thyroid Health Food (Hill's y/d) Live Up to the Hype?

Can a New Thyroid Health Food Live Up to the Hype?

A new prescription cat food promises to treat hyperthyroidism in cats. 
Maybe so, if the studies pan out. Where are those studies, anyway?


Dr. Eric Barchas
www.catster.com
May 3, 2012

In the blog post entitled, Can a New Thyroid Health Food (Hill's y/d) Live Up to the Hype?, Dr. Eric Barchas provides us with a good overview of what's wrong with all the hype associated with Hill's y/d diet.

As Dr. Barchas states in the beginning of his post (1): "For months, every veterinary publication I receive has been plastered with full-page advertisements for a new prescription cat food...... The new cat food is called Hill's y/d —or, more formally, Hill's® Prescription Diet® y/d™ Feline Thyroid Health on the company's website. Call me old-fashioned, but I am naturally suspicious of any food that has two ®s and a ™. Might the diet be more marketing ploy than medical breakthrough?"

For those of you who have followed my rants about what's wrong with Hill's y/d diet (2,3), you would be able to predict that this post made me smile.

So what's this diet all about and what's the problem with it? 

First of all, Hill's y/d diet certainly does offers another treatment option for hyperthyroid cats. The basis for how the diet works to control the hyperthyroid state is by severely limiting the amount of iodine in the y/d (the diet is actually iodine deficient).

Because thyroid hormone contains large quantities of iodine, the diet should reduce secretion of the hormone. Indeed, the clinical experience of practicing veterinarians to date indicate the this diet is effective in lowering serum T4 values in many hyperthyroid cats, although not always to levels that we would consider "low enough."

The biggest concerns are in regard to the long-term side effects of feeding an low iodine or iodine deficient diet to cats. For y/d to work, no other food can be fed for the rest of the cat's life — so the y/d diet, if successful, would potentially be fed for years to a cat suffering from hyperthyroidism.

As Dr. Barchas points out in his post, large, long-term safety studies are needed to determine what happens when cats with or without thyroid disease eat y/d months to years. Now I know it seems difficult to believe, but adequate long-term safety studies of cats fed this diet have yet to be done.

Because Hill's y/d is not a drug (although it's certainly being marketed as a replacement for methimazole), the company is not required to do long-term safety studies. And it's fairly clear that they have no intention of paying to have them done.

The bottom line: 

Again, Dr. Barchas says it better than I could do so let me quote the summary for his post (1): "In short, I believe that Hill's has unleashed y/d with too little research and too much hype. The food may turn out to be a veritable godsend, or it could be a disaster. Only time, and more studies, will tell.... 


For now, no matter how many fancy ads I see, I am hesitant to recommend the food unless a cat absolutely is not a candidate for any of the other three hyperthyroidism treatments."

Related links: 

1. To read the complete post by Dr. Barchas, click this link. 
2. To read my posts on y/d on the Animal Endocrine Clinic blog, click this link.
3. To read my posts on y/d on the Insights into Veterinary Endocrinology blog, click this link.

Pet Obesity: No Laughing Matter

As the number of Americans who are overweight has grown, studies show that the same statistics apply to our companion animals. About half of all dogs and cats in American homes are overweight or obese, up slightly from 2010, according to a recent study by the Association for Pet Obesity Prevention.

And although owners may think their pudgy dog or cat is cute, all that extra weight spells trouble the some 85 million U.S. pets who are considered overweight.

And many pet owners are finding that the extra pounds on a pudgy cat or dog can lead to severe secondary health problems. Just as diabetes, joint problems, and heart disease are more common in people who are obese, these diseases also are more common in overweight animals. The average cost of veterinary care for a diabetic dog or cat in 2011 was more than $900, according one pet insurance company. Treatment for arthritis and cruciate ligament tears in dogs, which can be caused by the strain of an overweight frame that weakens joints, cost pet owners an average of $2,000.

Last week, an interesting article the cost of pet obesity was published in the Wellness section of the New York Times. To read the complete article, entitled "Paying the Price of a Fat Pet," click this link.

• O'Connor, AO. Paying the Price of a Fat Pet. Well Pet Blog, The New York Times. April 20, 2012. 

Proper Nutrition and Lifestyle Essential for Cats

Cats have lived on the outer edges of human society for many thousands of years. However, domestication has changed cats relatively little. Diet options for cats in the wild have included consumption of small mammals, birds, and insects. These are meat or protein-based diets that contain little carbohydrate.

Cats, as a species, are strictly carnivorous. In many societies, they have been removed from their former free-roaming, active existence to a captive, indoor, sedentary one. They have also gone from consuming frequent, small meals of animals they could catch and kill to consuming prepared diets of human choosing.

Proper nutrition plays a key role in the prevention and management of many common feline endocrine disorders, including obesity, diabetes mellitus, and hyperthyroidism.

For more information, see this interesting blog post published last week in Cat Health News from the Winn Feline Foundation entitled, Cats: nutrition and lifestyle choices.

Related articles: 

• Zoran DL and Buffington CAT. Effects of nutrition choices and lifestyle changes on the well-being of cats, a carnivore that has moved indoors. Journal of the American Veterinary Medical Association 2011; 239: 596-606. 
• Zoran D. The carnivore connection to nutrition in cats. Journal of the American Veterinary Medical Association 2002; 221: 1559-67.

American Diabetes Alert Day: March 27, 2012

24th ANNUAL AMERICAN DIABETES ALERT DAY   

AMERICAN DIABETES ASSOCIATION

What is American Diabetes Association Alert Day?
Today is the American Diabetes Association Alert Day, which is held every year on the fourth Tuesday in March (1). The purpose of this Diabetes Alert Day is to call special attention to diabetes and to encourage everyone to find out if they are at risk.

While diabetes is often a hereditary condition, it is still possible to develop diabetes even if you have no known history of it in your family. In addition, type 2 diabetes is often preventable through regular medical checkups and a healthy lifestyle.

Why is Alert Day important? 
Diabetes is a serious disease that strikes nearly 26 million children and adults in the United States, and a  quarter of them—7 million—do not even know they have it. An additional 79 million, or one in three American adults, have prediabetes, which puts them at high risk for developing type 2 diabetes.

Unfortunately, diagnosis often comes 7 to 10 years after the onset of the disease, after disabling and even deadly complications have had time to develop. Therefore, early diagnosis is critical to successful treatment and delaying or preventing some of its complications.

The Diabetes Risk Assessment Quiz
To find out if you are at risk for diabetes, you can do so by taking the Diabetes Risk Assessment and then read more below about what you can do to prevent or manage type 2 diabetes. Click here to take the diabetes risk test.

This test asks users to answer simple questions about weight, age, family history, and other potential risk factors for prediabetes or type 2 diabetes. Preventative tips are provided for everyone who takes the test, including encouraging those at high risk to talk with their health care provider.

I took the test and it was quick and painless. The results of my test? I'm at medium risk for type 2 diabetes. Although I'm not overweight, I'm almost 60 years old (remember that type 2 diabetes increases with age), and my mother has had type 2 diabetes (she's lost weight so she's not on insulin now and is doing well).

Why is the Diabetes Alert Day important for diabetic cats and dogs? 
Diabetes is a serious disease that strikes more than 1 in every 200 cats. Like the situation in human diabetic patients, Type 2 diabetes is the most common form of diabetes in cats. Although dogs commonly develop diabetes, the form of diabetes they develop is not type 2 and more closely resembles type 1 diabetes (2).

Many of the risk factors for development of Type 2 diabetes in domestic cats are similar to man and include advancing age, obesity, and physical inactivity (3-7). Cats are obligate carnivores and have no need for dietary carbohydrates (2).  Feeding cats diets high in carbohydrate can increase blood glucose and insulin levels and may predispose cats to obesity and diabetes. Feeding low-carbohydrate, high-protein diets may help prevent diabetes for cats at risk.

The incidence of feline diabetes has progressively increased over the past few decades (6,7). In one study looking at records of cats with diabetes mellitus from 1970 through 1999 (7), prevalence increased significantly from only 8 cases per 10,000 in 1970 to 124 per 10,000 in 1999!

The exact cause of this increase in feline diabetes in not known but may relate to higher obesity rates and more cats being fed high-carbohydrate diets (6,7). Male cats appear to be at greater risk, representing approximately 60-70% of all diabetics (2-7). Increasing age also correlates with increasing risk of diabetes, with two-thirds of cats diagnosed when older than 10 years (3,5-7).

Feline diabetes is definitely treatable and need not shorten the cat's life span or life quality. Management of the diabetic cat should be a multipronged approach incorporating insulin, dietary therapy (to reduce carbohydrate load and induce weight loss if the cat is overweight), and management of any infection or concurrent condition.  With early intervention and good glycemic control, diabetic remission was achieved in over 75% of cats (2).

References:

1. American Diabetes Association Website: American Diabetes Alert Day, 2012.    
2. Rand JS, Fleeman LM, Farrow HA, et al. Canine and feline diabetes mellitus: nature or nurture? Journal of Nutrition 2004;134(8 Suppl):2072S-2080S. 
3. Baral RM, Rand JS, Catt MJ, et al. Prevalence of feline diabetes mellitus in a feline private practice. Journal of Veterinary Internal Medicine 2003;17:433.
4. Lederer R, Rand JS, Jonsson NN, et al. Frequency of feline diabetes mellitus and breed predisposition in domestic cats in Australia. Veterinary Journal 2009;179:254-258. 
5.  Panciera D, Thomas C, Eicker S, et al: Epizootiologic patterns of diabetes mellitus in cats: 333 cases (1980-1986). Journal of the American Veterinary Medical Association 1990;197:1504-1508. 
6. McCann TM, Simpson KE, Shaw DJ, et al. Feline diabetes mellitus in the UK: the prevalence within an insured cat population and a questionnaire-based putative risk factor analysis. Journal of Feline Medicine and Surgery 2007;9:289-99. 
7. Prahl A, Guptill L, Glickman NW, et al. Time trends and risk factors for diabetes mellitus in cats presented to veterinary teaching hospitals. Journal of Feline Medicine and Surgery  2007;9:351-358. 

FDA Video: Safe Handling of Pet Food in the Home

This week the U.S. Food and Drug Administration’s Center’s for Veterinary Medicine released a new video that cautions consumers about the health dangers — in the form of food-borne illness and disease—associated with feeding pet foods.

Based upon the unsettling assumption that pet food or treats might be contaminated, the video brings to light how your pet (and you) might avoid becoming ill if you follow some basic, commonsense food safety guidelines. And what steps to take should you suspect a pet food has adversely affected you or your pet.

Taking these precautions are very important in animals with endocrine disease, especially since many hormonal problems (e.g., diabetes, hyperadrenocorticism, hyperthyroidism) lead to a suppressed immune system and a decreased ability to ward off infections or other toxicities.

To see the video, click here to to directly to the FDA website or see the link below.

Link:

• FDA Website: Safe Handling of Pet Food in the Home (Video) http://www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm296800.htm?source=govdelivery

3 Brands of Chicken Jerky Treats Implicated in Causing Illness in Dogs

According to FDA records obtained by MSNBC.com, 3 brands of chicken jerky treats made in China have been connected to multiple canine illnesses following their consumption.

Brands most often cited in Priority 1 cases — instances in which the animal was younger than 11 years old and medical records were available — included Waggin' Train and Canyon Creek Ranch jerky or tenders, produced by Nestle Purina PetCare, and Milo's Kitchen Home-style Dog Treats, manufactured by Del Monte.

See the MSNBC/Vitals blog for the complete story.

FDA Released Q & A Regarding Jerky Treats from China

Continued complaints of dogs becoming ill after consuming chicken jerky treats from China has prompted the U.S. Food and Drug Administration to release a document entitled, "Questions and Answers Regarding Chicken Jerky Treats from China."

Click the link to go to the FDA website to read the content of this informative Q & A document.

Movement to Ban Chicken Jerky Treats Gains Momentum

The FDA has received some 600 complaints that chicken jerky treats from China are causing kidney disease, and in some cases death, in dogs across the U.S. But since extensive testing hasn't confirmed a contaminant, the FDA is only warning consumers about a possible problem. Newer tests, which are looking for heavy metal contaminants, are still pending.

Owners are pushing for further action, and one owner-geared Facebook group on the issue now has over 2,600 members (1).  The same group has posted a YouTube video that outlines the situation (2). One petition demanding the ban of jerky treats from China has acquired more than 3,300 signatures (3).

For more information, see the article posted today on the Food Safety News.com (4).

Links:

1. Facebook Group. Animal Parents Against Pet Treats Made in China!
2. YouTube Video. Animal Parents Against Pet Treats Made in China! 
3. Care2petitionsite. Ban All Poisonous Chicken Jerky Treats Imported From China
4. Andrews, J. Dogs fall ill as owners, vets, and lawmakers blame treats from China. Food Safety News. March 9, 2012.

Pet Obesity Epidemic Expanding, But Owners in Denial

Big Pets Get Bigger: 

Latest Survey Shows US Dog and Cat Obesity Epidemic Expanding 

The “fat pet gap” continues to widen according to the latest nationwide survey conducted by the Association for Pet Obesity Prevention (APOP). The fifth annual veterinary survey found 53 percent of adult dogs and 55 percent of cats to be classified as overweight or obese by their veterinarian. That equals 88.4 million pets that are too heavy according to veterinarians.

“The most distressing finding in this year’s study was the fact that more pet owners are unaware their pet is overweight.” comments APOP founder Dr. Ernie Ward. “22 percent of dog owners and 15 percent of cat owners characterized their pet as normal weight when it was actually overweight or obese. This is what I refer to as the “fat pet gap” or the normalization of obesity by pet parents. In simplest terms, we’ve made fat pets the new normal.”

 Perhaps even worse was the finding that the number of obese pets, those at least 30 percent above normal weight or a body condition score (BCS) of 5, continues to grow despite 93.4 percent of surveyed pet owners identifying pet obesity as a problem. The study found 24.9 percent of all cats were classified as obese and 21.4 percent of all dogs were obese in 2011. That’s up from 2010 when 21.6 percent of cats and 20.6 percent of dogs were found to be obese. “What this tells us is that more and more of our pets are entering into the highest danger zone for weight-related disorders.” says Ward.

Endocrinologist and fellow APOP Board member Dr. Mark Peterson agrees. “Obesity in dogs and cats is not just the accumulation of large amounts of adipose tissue, but it is associated with important metabolic and hormonal changes in the body. For example, heavy or obese cats are up to four times more likely to develop diabetes as a complication of their obesity. Losing weight can lead to reversal of the diabetic state in some of these obese cats.”

To read or download the complete article and results of the APOP survey, click here.

To learn more about pet obesity or the APOP, go to the Association for Pet Obesity Prevention website.

The Cooking of Commercial Pet Food

As an endocrinologist, I have now been in practice for a very long time (over 3 decades). But the longer I practice and care for dogs and cats with a variety of hormonal problems (from diabetes to thyroid disease to Cushing's syndrome), the more I realize the vital roles proper nutrition and diet make in the overall success of the patient's treatment.

Susan Thixton has an excellent website — TruthaboutPetFood.com —that I recommend to anyone interested in learning more about pet foods. After reviewing the website, you might want to subscribe to the 'Truth' Newsletter to keep up to date with her many reviews and alerts.

In one of this week's posts (The Cooking of Pet Food), Susan provides a link to an article published on the Pet Food Institute website on "How Pet Food Is Made" written by Greg Alldrich, PhD, a consultant to the pet food industry. In this article, Dr. Alldrich explains that the cooking process of pet foods — both kibble and canned —"provides a number of benefits, including convenience, enhanced flavor and texture, improved consistency, pathogen control and decreased spoilage."

He continues "However, extensive processing can increase variability, destroy essential nutrients and create unwholesome by-products. From a formulator’s perspective, this creates a dilemma regarding how to assure the diet is sufficiently fortified while avoiding excess after accounting for processing effects."

In this article, Dr. Alldrich encourages the pet food industry to learn more about how pet food ingredients are affected during the cooking process.

Links:

• TruthAboutPetFood.com website http://www.truthaboutpetfood.com/
• Pet Food Institute website www.petfoodinstitute.org 
• The Cooking of Pet Food www.truthaboutpetfood.com/articles/the-cooking-of-pet-food.html
• How Pet Food Is Made www.petfoodinstitute.org/Index.cfm?Page=HowPetFoodisMade

Warning: Serious Illness In Dogs Linked To Chicken Jerky Treats

Chicken jerky treats imported from China appear to be responsible for hundreds of recent reports of mysterious illnesses that can mimic diabetes mellitus in dogs. This syndrome has results in the death of some deaths of the affected dogs, which has prompted a renewed warning for pet owners by the Food and Drug Administration (FDA).

In 2006, China was responsible for the melamine contamination of the food additives known as wheat gluten and rice protein concentrate. This triggered a nationwide recall of several dog food items from a variety of manufactures. This time the item of concern is chicken jerky treats.

FDA issued a cautionary warning regarding chicken jerky products to consumers in September 2007 and a Preliminary Animal Health Notification in December of 2008. After seeing the number of complaints received drop off during the latter part of 2009 and most of 2010, complaints to the FDA started increasing again in 2011. In November, the FDA announced an official cautionary warning for consumers feeding chicken jerky treats to their dogs (1).

Now amid reports of more than 500 dogs sickened by chicken jerky pet treats imported from China, FDA officials have begun collecting and testing chicken jerky treats upon import, analyzing samples for evidence of dangerous toxins. To date there hasn't been a specific cause or contaminant identified, but the FDA is looking into melamine and diethylene glycol, chemicals used in plastics and resins.

Dog Treats can Cause Fanconi Syndrome and Kidney Failure 

Dogs that consume the imported chicken jerky food products routinely can develop a Fanconi-like syndrome (2). This is an uncommon condition which affects the kidneys and causes them to leak glucose (sugar) and other electrolytes into the urine.

Clinical signs or symptoms of Fanconi syndrome in dogs can include decreased appetite, decreased activity, vomiting, and increased water consumption and/or increased urination. Blood tests may indicate kidney failure (increased serum urea nitrogen and creatinine concentrations).  Urine tests may indicate Fanconi syndrome (high amounts of glucose in the urine). The increased glucose excretion in the urine (glycosuria) can be confused with diabetes mellitus, but dogs with Fanconi syndrome maintain a normal blood glucose level. If left untreated, severe renal failure can develop, and death is possible.

Until more is known, the FDA has made the following recommendations (1):

• Chicken jerky products should not be substituted for a balanced diet and are intended to be fed occasionally in small quantities. 
• Consumers that feed chicken jerky products to their dogs should monitor for symptoms of decreased energy, decreased appetite, vomiting, diarrhea, increased water consumption, and increased urination. 
• If a dog develops any of these signs, you should stop feeding the chicken jerky product.
• Owners should consult their veterinarian if signs are severe or persist for more than 24 hours. 
• Veterinarians and consumers alike should report cases of animal illness associated with pet foods to the FDA’s Pet Food Complaint site. 

Bottom line

At this time, I would encourage you to only purchase products that are made in the United States. The first thing that I do when looking at a bag of pet treats is turn it over and look for the country of origin. At least for now, I would not buy any treats that are imported from China.

I also encourage pet owners to limit treats to less than 15 percent of the overall calorie intake for their dogs. Please keep in mind that raw or cooked vegetables such as carrots, green beans, and broccoli make wonderful treats, especially for those dogs who are struggling to lose weight.

References:

1. FDA website. FDA Continues to Caution Dog Owners About Chicken Jerky Products
2. Hooper AN, Roberts BK. Fanconi syndrome in four non-basenji dogs exposed to chicken jerky treats. Journal of the American Animal Hospital Association 2011;47:178-187.

3 Things You Can Do To Help Your Dog Lose Weight

We are an overweight society and our pets are no different. Over half of American dogs are overweight, and up to 25% are obese.

Dogs with obesity are more prone to a variety of health problems, just like people. These include an increased incidence of diabetes, asthma, and hip and joint problems.

Losing weight can help overweight dogs become healthier and happier. It can also help them to live longer.

Here are some things you can do tomorrow that can help your dog start losing weight.

1. Cut the treats in half. If you must feed treats, cut them in half or give half as many in a day. This can help cut calories. Switching to carrots may help.
2. Exercise your dog more. Ask your vet if your pet is healthy enough to tolerate more exercise. If you play with your dog every day, play a few minutes longer. If you go on a walk, go a little farther. This helps burn calories.
3. Lower the amount of calories your dog consumes each day by changing your dog's food. I like to use diets lower in carbohydrates and higher in protein.

There are several diets formulated for weight loss. Discuss it with your veterinarian to learn more. But remember, whatever diet is chosen, portion control is a big issue.

Although the most common explanation for an overweight pet is simply a lack of exercise and too much to eat. But what if you feed your dog sensibly, exercise adequately, and your dog still has a weight problem?

There could be a number of underlying diseases may be causing your dog to become overweight or obese. Hormonal diseases such as hypothyroidism and Cushing’s syndrome commonly cause weight gain. Steroid pills or tablets with cortisone-like drugs could also be contributing to the obesity.

If these 3 simple hints don't help, ask your veterinarian if an underlying disease could be part of the problem.