History

Dog Body Weight Management

Key Message

WALTHAM has contributed to the understanding of body weight management in the dog by:

  • Establishing the first pet weight management referral clinic in Europe in collaboration with the University of Liverpool and Royal Canin.
  • Developing the S.H.A.P.E.TM system to help owners recognise weight issues in their pet.
  • Generating epidemiological data on the prevalence and risk factors of obesity in dogs.
  • Showing that quality of life is reduced in obese dogs but improves after successful weight loss.
  • Demonstrating that inflammatory markers are elevated in obese dogs, and decrease with weight loss, and investigating the pathogenesis of obesity-related diseases.
  • Generating insight into the risk of hypertension associated with obesity.
  • Showing that increasing dietary fibre levels improves weight loss when added to a high protein diet.
  • Generating insight into the precision of dual energy x-ray absorptiometry in dogs.

Background

Obesity is the accumulation of excessive amounts of body fat. Dogs can be defined as being overweight if their bodyweight is 15% above ideal and classed as obese if they are more than 30% above their ideal weight. Estimates of the prevalence of obesity and being overweight are in the range of 24-59% for dogs (Edney and Smith 1986; McGreevy et al. 2005; Holmes et al. 2007; Courcier et al. 2010).

Being overweight and obese are consequences of energy intake exceeding requirement at some stage in the dog's life. Older dogs are at increased risk of obesity, as are females compared with males, neutered dogs (compared with entire animals), and dogs receiving less exercise (Holmes et al. 2007). Owners older than 55 years of age are also at a greater risk of owning an obese dog (Holmes et al. 2007). Owner attitudes to their pet also play a role, since the owners of overweight dogs have a tendency to anthropomorphise their pet and show affection through feeding (McCune et al. 2008).

Maintaining a healthy bodyweight is important for the dog's health. Obese dogs have a reduced lifespan (Kealy et al. 2002) and even moderately overweight dogs are at risk of the early onset of chronic health problems (Laflamme 2012). Health risks associated with overweight/obesity in dogs include osteoarthritis (Marshall et al. 2009), hypertension (Montoya et al. 2006), and cancer (Perez Alenza et al. 1998; 2000). Obesity also reduces the dog's quality of life (German et al. 2012).

Dogs are scavengers by nature and given free access to food many will overeat and gain weight. This means that providing pet dogs with the appropriate amount of food is vital if they are to maintain a healthy bodyweight. Common feeding practices can result in overfeeding. Many owners use measuring cups to guide how much extruded dry kibbled food to feed their pet. However, measuring cups have been shown to be imprecise and inaccurate, resulting in errors that, over time, could contribute to insidious weight gain and the failure of weight management programmes (German et al. 2011). It is vital to understand how dogs should best be fed to support the maintenance of a healthy bodyweight: how much to feed the dog, when to feed it and how.

Why WALTHAM is Interested

Obesity is the most common form of malnutrition that affects pets. Obese pets are not healthy pets. In order to provide diets optimised for the treatment of obesity and maintenance of a healthy body weight (prevention of obesity), it is vital to fully understand how much to feed dogs, what to feed, and how to feed it. Research in this area is ongoing.

Approach

Together with the University of Liverpool and Royal Canin, WALTHAM established the first pet weight management referral clinic in Europe in 2003.

An easy-to-use algorithm-based system was developed to help owners recognise weight issues in their pet. The epidemiology of obesity was studied to better understand the risk factors, along with the role of inflammatory markers and risk for hypertension. The effect of fibre on satiety and weight loss was also investigated.

Capability Development (Clinic)

In collaboration with the University of Liverpool and Royal Canin, WALTHAM established the first pet weight management referral clinic in Europe.

The Royal Canin Weight Management Clinic at the University of Liverpool's Small Animal Hospital, UK, was established in 2003. It is the first pet weight management referral clinic in Europe and was set up to address the direct health concerns linked to obesity and improve understanding of pet obesity.

Veterinarians from any general practice in the UK can refer overweight dogs to the clinic. The patients receive a thorough medical examination, and are then given a specific dietary plan and exercise regimen to follow over subsequent weeks. 

Whilst treating overweight dogs, the clinic compiles a large amount of data about the obesity problem in pets. This information is used to improve the understanding of the causes of obesity in pets, enabling the refinement of methods of treatment and prevention. With sufficient cases, it will be possible to establish whether certain breeds have a higher risk of obesity. The link between obesity and disease is under investigation, with the aim of understanding how such diseases arise so that appropriate treatment and prevention strategies can be recommended.

Capability Development (S.H.A.P.E.TM)

The S.H.A.P.E.TM system helps owners recognise weight issues in their pet.

Existing body condition scoring charts for dogs (Laflamme 1997; Mawby et al. 2004) require training and a degree of expertise, making them less useful for pet owners to use themselves.

The S.H.A.P.E.TM (Size, Health And Physical Evaluation) system was designed with pet owners in mind, and was developed and validated in collaboration with the University of Liverpool (Figure 1). It uses similar visual and palpable characteristics as the previous scoring systems, but provides a series of questions prompting the owner to examine their pet in a systematic and sequential manner. This allows the owner to assess the fat covering the ribs, and directs them to select the most appropriate body condition score (from 7 categories: A, underweight; to G, obese).

S.H.A.P.E™ graph
WALTHAM S.H.A.P.E™ table

S.H.A.P.E™ score
WALTHAM S.H.A.P.E™ table

Figure 1: WALTHAM S.H.A.P.E.TM guide for dogs

The S.H.A.P.E.TM system was validated in 71 client-owned dogs (German et al. 2006) referred to University of Liverpool clinics. The owners scored their pet using the S.H.A.P.E.TM system alongside assessors experienced using S.H.A.P.E.TM Dogs also underwent dual-energy X-ray absorptiometry (DXA) to determine the amount of body fat. The study showed that the scoring system was reliable in the hands of experienced operators, and that correlation was good between experienced operators and scores determined independently by the owners who had no prior experience of body condition scoring. The S.H.A.P.E.TM system also correlated well with body fat mass calculated by DXA.  (Figure 2)

Percentage body fat
Reproduced from German AJ, Holden SL, Moxham GL, Holmes KL, Hackett RM, Rawlings JM. A simple, reliable tool for owners to assess the body condition of their dog or cat. J Nutr 2006. 136(7supp):2031S-2033S

Figure 2: Association between estimated percentage of body fat, determined by dual energy X-ray absorptiometry (DXA), and body condition score determined by the S.H.A.P.E.TM system (German et al. 2006). Correlation between body fat measured by DXA and S.H.A.P.E.TM score, P<0.0001. S represents the estimated standard deviation of the error in the model. R2 represents the coef?cient of determination, which indicates how much variation in the response is explained by the model. Data were analysed by simple linear regression

This study shows that the S.H.A.P.E.TM system is a reliable and useful way for owners to monitor their pet’s body condition.

Discovery (Epidemiology)

About half of all dogs are overweight or obese, especially older dogs, neutered dogs, and female dogs

It is essential to understand how many dogs in the population are obese, and what the risk factors for this are. WALTHAM has contributed to the body of epidemiological data on canine obesity.

A 6-month survey of 8268 dogs visiting 11 UK veterinary practices in 1983 found that 21% were obese and 3% were grossly obese (Edney and Smith 1986). Labradors were the breed most likely to become obese, followed by Cairn terriers, cocker spaniels, long haired Dachshunds, Shetland sheepdogs, basset hounds, cavalier King Charles spaniels, and beagles (Edney and Smith 1986). Neutering was found to approximately double the risk of obesity (Edney and Smith 1986). This study used a 5-point scale to categorise body condition.

Subsequently, the validated 7-point S.H.A.P.E.™ scale was used to assess body condition and a questionnaire was designed to evaluate risk factors for obesity in 399 dogs attending an equestrian event (Holmes et al. 2007). The study found that 37% of dogs were overweight and 15% were obese (Holmes et al. 2007). When owners were asked if they thought their dog was overweight, only 32% of those with overweight or obese dogs agreed (Holmes et al. 2007). Owners who were overweight themselves owned 74% of the overweight/obese dogs (P=0.008) (Holmes et al. 2007). Body condition score was significantly associated with exercise level, and was higher in older dogs (7.5–9.9 years), female dogs, neutered dogs, and in those with older owners (aged >55 years) (Holmes et al. 2007). No association with obesity was found for breed size, owner activity level, feeding snacks and treats, or the number of hours the dog was left alone each day (Holmes et al. 2007).

These studies provide insight into the risk factors for obesity in dogs. The most recent data suggest that about half of all dogs are overweight or obese (Holmes et al. 2007).

Discovery (Quality of Life)

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

A study in collaboration with the University of Liverpool, the University of Glasgow, and Royal Canin used a questionnaire to determine health-related quality of life in obese dogs (German et al. 2012).

A total of 50 obese dogs were recruited at the Royal Canin Weight Management Clinic (German et al. 2012). The owners were asked to complete a validated standardised questionnaire, before and after weight loss. The completed questionnaire responses were transformed into scores (scale 0–6) corresponding to each of four domains: vitality, emotional disturbance, anxiety, and pain. Successful weight loss was achieved by 30 of the dogs.

Lower vitality and higher emotional disturbance scores were found for dogs failing to complete their weight loss programme compared with those successfully losing weight (P=0.03 for both) (German et al. 2012). Successful weight loss (30 dogs) was associated with increased vitality scores (P<0.001), and decreased scores for both emotional disturbance (P<0.001) and pain (P<0.001); but there was no change in anxiety (P=0.09) (German et al. 2012). The change in vitality score was positively associated with percentage weight loss (rp 0.43, P=0.02) and percentage body fat loss (rp 0.39, P=0.03) (Figure 3) (German et al. 2012).

Before and after
Reproduced from German AJ, Holden SL, Wiseman-Orr ML, Reid J, Nolan AM, Biourge V, Morris PJ, Scott EM. Quality of life is reduced in obese dogs but improves after successful weight loss. Vet J. 2012 Jun;192(3):428-34

Figure 3: Health-related quality of life before and after weight loss in 30 obese client-owned dogs (German et al. 2012). Domains assessed were vitality (a), emotional disturbance (b), anxiety (c), and pain (d), whereby improved quality of life manifests as increased vitality score, and decreased emotional disturbance, anxiety, and pain scores. The boxes depict median (horizontal line) and inter-quartile range (top and bottom of box), the vertical lines show the 10th and 90th percentiles, and outliers are shown as separate points. Weight loss was associated with improved vitality, decreased emotional disturbance, and decreased pain score (P<0.001 for all)

These data show that the health-related quality of life of obese dogs improves when they successfully lose weight.

Discovery (Pathogenesis)

Inflammatory markers are elevated in obese dogs, and decrease with weight loss

Human obesity is characterised by derangements in inflammatory adipokine production from adipocytes, but it was unclear if obese dogs were similarly affected.

In a study in collaboration with the University of Liverpool, the Universitat Autònoma de Barcelona, Spain, and Royal Canin, inflammatory adipokines and insulin sensitivity were assessed before and after weight loss in 26 obese dogs referred to the Royal Canin Weight Management Clinic (German et al. 2009).

Weight loss led to a significant decrease in plasma tumour necrosis factor-alpha concentrations (P=0.002) (German et al. 2009). Before weight loss, plasma tumour necrosis factor-alpha was above the detectable limits of the assay in 11 (42%) of the dogs; after weight loss, only 3 dogs (12%) had these high levels (P=0.016) (German et al. 2009).  Weight loss led to significant decreases in the inflammatory markers haptoglobin and C-reactive protein (Figure 4)(German et al. 2009).

Dog Obesity WDC63
Reprinted from German AL, Hervera M, Hunter L, Holden SL, Morris PJ, Biourge V, Trayhurn P. Improvement in insulin resistance and reduction in plasma inflammatory adipokines after weight loss in obese dogs. Domest Anim Endocrin 2009.37(4):214-216 with permission from Elsevier

Dog Obesity WDC63(2)
Reprinted from German AL, Hervera M, Hunter L, Holden SL, Morris PJ, Biourge V, Trayhurn P. Improvement in insulin resistance and reduction in plasma inflammatory adipokines after weight loss in obese dogs. Domest Anim Endocrin 2009.37(4):214-216 with permission from Elsevier

Figure 4: Plasma CRP and haptoglobin decreased significantly after weight loss (German et al. 2009). The boxes depict median (horizontal line) and interquartile range (top and bottom of box), the vertical lines show range, and outliers are shown as separate points

Insulin resistance was found to be correlated with degree of adiposity, and insulin sensitivity improved upon weight loss (German et al. 2009).

As in humans, a concurrent decrease in tumour necrosis factor-alpha and adipose tissue mass in dogs suggests a role for this adipokine in insulin resistance of obesity. These data contribute to the understanding of the pathophysiology and health risks of obesity, and suggest that weight loss may be beneficial for the dog’s health.

Canine adipocytes are highly responsive to inflammatory mediators with the induction of major increases in the production of inflammation-related adipokines

A study conducted in collaboration with the University of Liverpool showed that canine adipocytes express and secrete key adipokines. Canine adipocytes are highly responsive to inflammatory mediators, especially lipopolysaccharide, with the induction of major increases in the production of inflammation-related adipokines (Ryan et al. 2010). The inflammatory mediators lipopolysaccharide and tumour necrosis factor ? had major stimulatory effects on the expression and secretion of interleukin-6, MCP-1 and tumour necrosis factor ?. Inflammation may play a role in the pathophysiology of obesity-associated diseases in the dog.

The induction of 11?-HSD-1 expression may have implications for the pathogenesis of obesity and its associated diseases in the dog

The expression and activity of the enzyme 11?-hydroxysteroid dehydrogenase 1 (11?-HSD-1), which reactivates inert cortisone into cortisol, is increased in white adipose tissue in obese humans, and may contribute to the adverse metabolic consequences of obesity. The extent to which 11?-HSD-1 contributes to adipose tissue function in dogs was unknown.

A study was undertaken, in collaboration with the University of Liverpool, to examine 11?-HSD-1 gene expression and its regulation by proinflammatory and anti-inflammatory agents in canine adipocytes (Ryan et al. 2011). Real-time PCR was used to examine the expression of 11?-HSD-1 in canine adipose tissue and canine adipocytes differentiated in culture. Tissue was provided by dogs that had been euthanised by an animal shelter for reasons unrelated to the study.

The mRNA encoding 11?-HSD-1 was identified in all the major white adipose tissue depots in dogs and also in liver, kidney, and spleen (Ryan et al. 2011). The inflammatory mediators lipopolysaccharide and tumour necrosis factor ? had a main stimulatory effect on 11?-HSD-1 gene expression in canine subcutaneous adipocytes, but IL-6 had no significant effect (Ryan et al. 2011). 

This study suggests that induction of 11?-HSD-1 expression, by the pro-inflammatory cytokine tumour necrosis factor ? and by lipopolysaccharide may have implications for the pathogenesis of obesity and its associated diseases in the dog.

Insight Generation (Hypertension)

Body condition score is signi?cantly correlated with systolic, diastolic, and mean arterial blood pressure

This study was conducted in collaboration with the Las Palmas de Gran Canaria University, Spain, and examined the association between weight status and hypertension in otherwise healthy dogs.

A total of 122 client-owned dogs from Spanish urban households were recruited and evaluated during routine veterinary visits (Montoya et al. 2006). Body condition score was assessed using a 9-point scale, and blood pressure measured in triplicate by oscillometry with the cuff placed around the base of the dog’s tail or hind leg. Hypertension was de?ned as systolic ?150 mmHg and diastolic ?95 mmHg.

The body condition scores of the dogs were 4 (underweight, n=14 dogs), 5 (ideal, n=28), 6 (overweight, n=17), 7 (heavy, n=26), 8 (obese, n=27), and 9 (grossly obese, n=10) (Montoya et al. 2006; Laflamme 1997).

There were signi?cant correlations between body condition score and systolic pressure (r 0.227, P=0.012), diastolic pressure (r 0.494, P<0.001), and mean arterial pressure (r 0.461, P<0.001) (Figure 5) (Montoya et al. 2006).

blood pressure
Reproduced from Montoya JA, Morris PJ, Bautista I, Juste MC, Suarez L, Pena C, Hackett RM, Rawlings J. Hypertension: a risk factor associated with weight status in dogs. J Nutr 2006.136(7supp):2011S-20123S

Blood Pressure part 2
Reproduced from Montoya JA, Morris PJ, Bautista I, Juste MC, Suarez L, Pena C, Hackett RM, Rawlings J. Hypertension: a risk factor associated with weight status in dogs. J Nutr 2006.136(7supp):2011S-20123S

Blood Pressure part 3
Reproduced from Montoya JA, Morris PJ, Bautista I, Juste MC, Suarez L, Pena C, Hackett RM, Rawlings J. Hypertension: a risk factor associated with weight status in dogs. J Nutr 2006.136(7supp):2011S-20123S

Figure 5: Relationship between body condition score and blood pressure measures in dogs (Montoya et al. 2006). Values are mean ± SD.  Data assessed using linear regression. Correlation between body condition score determined by La?amme method and systolic blood pressure determined by oscillometry (r = 0.227, P=0.012) (A). Correlation between diastolic blood pressure and body condition (r = 0.494, P<0.001) (B). Correlation between body condition score and mean arterial pressure (r = 0.461, P<0.001) (C)

There was also a signi?cant correlation between body condition score and the prevalence of hypertension (r 0.271, P<0.001) (Montoya et al. 2006).

The contribution of body condition score to blood pressure variance was relatively small, however, accounting for 5.2% (systolic), 24.4% (diastolic), and 21.2% (mean arterial pressure) of the variability (Montoya et al. 2006). These associations remained signi?cant when controlling for breed, age, sex, and neuter status, although the correlation between body condition score and systolic blood pressure was not signi?cant when controlled for size (Montoya et al. 2006).

These data suggest that weight status may be a contributory factor in secondary hypertension.

Discovery (Fibre)

Increasing dietary fibre levels improves weight loss when added to a high protein diet

Fibre is often advocated as a dietary bulking agent to reduce hunger during weight reduction programmes, although there has been some debate about its effectiveness in this regard.

Two controlled studies at WALTHAM used diets with different levels and types of fibre, fed at the same restricted energy intake to 6 dogs for 12 days in a latin square design (Butterwick et al. 1994, Butterwick and Markwell 1997). Satiety was measured by offering the dogs a challenge meal and measuring their food intake. This was done on two occasions in each study, with the challenge meal offered for a period of 15 minutes exactly 3 hours after the main meal. The studies found there was no significant effect of fibre type or fibre level (Butterwick et al. 1994; Butterwick and Markwell 1997) on the amount of food eaten in the challenge meal. These studies showed that the addition of moderate, or even high, levels of either soluble or insoluble fibre to a commercial low calorie diet had no beneficial effects on satiety when fed to dogs at an energy intake compatible with weight reduction (Butterwick et al. 1994, Butterwick and Markwell 1997).

Together, these studies suggest that fibre might not affect satiety. However, the weight of literature contradicts this, and fibre has been shown to be satiating when included in a high protein diet (Weber et al. 2007). Differences in the findings of studies in this area might be attributable to study design and methodology, diet format and formulation, dog population, and methodology used to calculate dietary energy content.

In a subsequent study in collaboration with the University of Liverpool and Royal Canin, the effect of a high fibre diet on weight loss was investigated. A high protein diet was formulated with either high or moderate levels of fibre, and fed to 42 client-owned dogs with naturally-occurring obesity referred to the Royal Canin Weight Management Clinic (German et al. 2010). Overall, weight loss was greater on the high-fibre diet (median 32%) compared with the moderate fibre diet (median 20%, P=0.016) (German et al. 2010). The rate of weight loss was also faster (1% versus 0.7% per week, P=0.028 Figure 6), and the fat mass loss was greater (58% versus 37%, P=0.002) for the high-fibre diet compared with the moderate fibre diet (German et al. 2010).

Weight loss
Reprinted from German AJ, Holden SL, Bissot T, Morris PJ, Biourge V. A high protein high fibre diet improves weight loss in obese dogs. Vet J.2010.183(3):294-297 with permission of Elsevier

Figure 6: Weight loss in dogs fed a high protein diet with either moderate (n=27, HPMF) or high (n=15, HPHF) levels of dietary fibre (German et al. 2010). The boxes depict median (horizontal line) and inter-quartile range (top and bottom of box), with vertical lines showing range and outliers shown as separate points

This study shows that weight loss and body composition changes are better with a high-protein high-fibre diet rather than one formulated to include moderate levels of fibre (German et al. 2010).

Insight Generation (DXA)

Dual-energy x-ray absorptiometry has excellent precision for assessing body composition in dogs

This study was conducted in collaboration with the University of Liverpool and Royal Canin, and aimed to validate the precision of dual energy x-ray absorptiometry (DXA) for measuring body composition in dogs.

Body composition was assessed repeatedly in 10 adult canine cadavers by DXA (Raffan et al. 2006). The subjects (obtained as a consequence of fatal natural illness) represented a variety of different breeds, ages, and genders. The study used cadavers to avoid the ethical concerns of performing repeated (experimental) scans in healthy live animals. The scanning procedures were completed within 1 hour of death, and each subject was scanned 6 times, alternating between dorsal and lateral recumbency. This represented the maximum number of scans feasible to perform before the onset of rigor mortis.

The precision of body composition analysis by DXA was excellent, although it was marginally better in dorsal recumbency than in lateral recumbency, and differed slightly between operators.

The study showed that DXA scanning is a precise method of body composition analysis in dogs (Raffan et al. 2006). The precision obtained supports the use of sequential scans to follow changes in body composition in clinical patients. However, differences were demonstrated between both body positions and operators, so the sequential use of DXA scans in a single patient requires that protocols are standardised as far as possible. Dorsal positioning is recommended because this is what is used in humans, and it lends itself to better compartmental analysis for the future.

References

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German AJ, Holden SL, Mason SL, Bryner C, Bouldoires C, Morris PJ, Deboise M, Biourge V. Imprecision when using measuring cups to weigh out extruded dry kibbled food. J Anim Physiol Anim Nutr (Berl). 2011 Jun;95(3):368-73.


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Ryan VH, Trayhurn P, Hunter L, Morris PJ, German AJ. 11-Hydroxy-?-steroid dehydrogenase gene expression in canine adipose tissue and adipocytes: stimulation by lipopolysaccharide and tumor necrosis factor ?. Domest Anim Endocrinol. 2011 Oct;41(3):150-61.


Ryan VH, German AJ, Wood IS, Hunter L, Morris P, Trayhurn P. Adipokine expression and secretion by canine adipocytes: stimulation of inflammatory adipokine production by LPS and TNFalpha. Pflugers Arch Eur J Physiol. 2010 Aug;460(3):603-16.


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