Sunday, December 21, 2014

Pet obesity: Underdiagnosed and undertreated

In 2012, over 180 million pets were seen by a veterinarian yet left the vet hospital without treatment for a major disease. They were not treated for their overweight or obese condition. The one single condition that could affect the quality of these pets' future lives was completely ignored.

Pet obesity: Underdiagnosed and undertreated

In 2012, over 180 million pets were seen by a veterinarian yet left the vet hospital without treatment for a major disease. They were not treated for their overweight or obese condition. The one single condition that could affect the quality of these pets' future lives was completely ignored.

Why? Because both owners and veterinarians fail to recognize the seriousness of the condition. And neither wants to spend the time and effort necessary for successful treatment. Treatment of the overweight condition would add years to pets' lives and actually be profitable for veterinary practices.

Owner and Veterinary Attitudes about the Overweight Condition in Pets

A study of Australian and American pet owners found that 70 percent of pet owners underestimated their pets' fitness compared to professional assessment. These results were verified in a recent Canadian study. Worse still was that fewer than 1 percent of the 32 percent of pet owners who did agree that their pets were overweight thought that it was a problem for their pets.

Veterinarians fared no better. The above study found that veterinarians only diagnosed a condition of overweight in 2 percent of their cases despite assigning an overweight or obese body condition scores (BCS) to 28 percent of those patients. Veterinarians recorded body weights for just 70 percent of their patients and recorded a BCS for only a scant 28 percent of those same patients. BCS is a far more accurate assessment of fitness and body fat percent than weight is, yet it is widely ignored in general veterinary practice.

Why Treatment for Excess Weight in Pets is Important

Virtually everyone agrees that the overweight or obese condition is at least a nuisance. But health ramifications are not seriously recognized as evidenced by the above study. Fat is still recognized as an accumulated fuel source and insulation. Even veterinarians have been slow to accept the fact that fat, in both humans and pets, is the largest endocrine organ in the body.

Endocrine glands secrete hormones that direct body activity. Most pet owners are familiar with pituitary, thyroid, and adrenal glands and the diseases associated with those glands. Fat is also an endocrine gland. Scientists have identified over 100 hormones secreted by human fat and over 30 secreted by the fat of cats and dogs. Unfortunately, the majority of the hormones produced by fat promote inflammation.

The inflammatory response is the rallying of white blood cells and chemicals to combat an infection that doesn’t exist. The body of an overweight or obese pet is in this protective mode 24/7/365. This is true for even the mild to moderately overweight. This chronic state of inflammation is what is believed to cause diabetes mellitus, certain kidney diseases, respiratory diseases, arthritic conditions, and even cancer.

But there is great news. Studies show that even small losses in fat result in immediate decrease of inflammation and it appears to be permanent. A serious weight loss program can ultimately have a major impact on the future health of pets. In fact, the famous twelve year Purina study of golden retrievers (a breed known for obese tendencies) found that puppies and dogs maintained at an ideal BCS lived almost two years longer than their littermates. So why don’t more veterinarians promote weight management?

The Veterinary Paradigm

The history of a veterinarian’s role has traditionally been that of the healer. To this day, the traditional 15-20 minute appointment schedule is the norm in the majority of veterinary hospitals. Its sole goal is to identify the ailment, design the diagnostic and treatment plan, and move on to the next exam room. This has been the paradigm for our profession for over three decades.

Only recently has there been a paradigm shift from concentrating on illness to promoting wellness. But most of these programs focus on vaccines, parasite prevention, and dentistry. The 15-20 minute appointment is still the norm.

Nutritional guidance, weight loss and weight management require more than short appointments. Discussing lifestyle changes like counting calories, managing feeding strategies, and implementing activity programs require much longer sessions. Owners of weight loss patients often need on-site support, and phone coaching, and hand-holding between hospital visits. Veterinarians have been slow to integrate a separate appointment system for wellness.

What veterinarians are missing is that this can actually be profitable for them. Studies indicate that 60 percent of their patients are in need of these services, yet few veterinarians offer serious programs. Unfortunately, we veterinarians are a thick lot. It is going to take increased pressure from pet parents to impact the veterinary practice paradigm. Pet owners must lead the war on pet obesity. Demand will drive the necessary changes to veterinary practice.

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