Good evening everybody and welcome to tonight's webinar. I nearly said members webinar because it's Thursday night, but we are very pleased to have Royal Canon as our sponsors tonight. And a huge big thank you to Royal Canon for sponsoring so that we could open this webinar up to all of you lovely attendees.
Just a little bit of housekeeping for those of you that don't know us. If you want to ask a question, just move your mouse over the screen. You will see that your little control bar pops up at the bottom, normally, little black bar, there's a Q&A box there.
Just click on that, type your questions in there. They will all come through to me and I will hold those over and then we will discuss them with Nicola at the end. I forgot to tell you that my name is Bruce Stevenson and I am the host tonight.
But way more importantly than that, is our presenter tonight. So Nicola works as the head medical nurse at the veterinary hospital in Plymouth in the UK. She graduated from Habsbury College with an honours degree in equine Sciences.
And then in 2002, she went on to qualify as a veterinary nurse. Nicola sits on the veterinary product Committee for the veterinary medicines Directorate. She has written for many veterinary publications and textbooks, and is also the editor for Aspinall Complete Textbook of Veterinary Nursing, as well as sitting on the editorial board of the veterinary nurse.
Nicola has won the BVNA Blue Cross Award for animal welfare in 2010. Various SQP awards in 2011, 2012, 2013, 2014. And the College of Animal Welfare Professional Development Award in 2012.
Nicola is currently studying for a master's degree in advanced veterinary nursing at the Glasgow University. Nicola, welcome to the webinar, vet, and it's over to you. Hi, thank you very much, Bruce, and thank you everyone for joining us tonight.
For me, it's quite late. I did start work at sort of just before 7 a.m.
So it's been a long day for me, so I'm really appreciative for everybody coming online tonight to listen to me talking. We're we're talking about nutrition in older animals, and it's it's a really sort of Passion of mine because we see so many older animals and our knowledge about, Nutrition in in these older pets is, it changes, it evolves, it develops. So what we, well, when I started nursing, it is actually probably quite a long time ago now, what we learned then is not the same as we know now.
So it's changing all the time and my pets are older, and so, you know, we, we need to keep up with these things. So we're gonna really be looking at what things have changed when it comes to, to nutrition. So.
Yeah, I it's like what is senior, but. There's no real definition of what is a senior dog, what is a senior cat. I'm gonna say, it really does depend on which pharmaceutical company you talk to, which nutrition company you talk to, you know, which, governing body, which, you know, cat association, and so on.
So we all have slightly different definitions. And in dogs, it's really difficult because we're all, we are size dependent. So my little Jack Russell, it's, you know, 10 years of age, it's gonna be really different to a Rottweiler at 10 years of age, you know, whereas senior it's, it's really, you know, does differ.
Interestingly, we know at the moment with the sort of pandemic puppies and all these sort of things that our populations have. Just leapt up and I've put some figures here because I just want to just just frighten the pants off of you a little bit. Does the incoming doom.
So in 2018, PFMA, which is the Pet Food Manufacturers Association, estimated there were 9 million dogs and 8 million cats in the UK. During the pandemic or over the pandemic, it is now estimated that we have 12 million dogs and 12 million cats in the UK. That is massive jumps.
So we know we're seeing more vaccination, you know, puppy kitten vaccinations, we're having to do more neutering, and so on. But let's just tick that calendar forward a few years, and when these, you know, let's look at 8 years' time when all of these are gonna become seniors, how are we gonna deal with it then? You know, what happens when they start becoming poor.
You know, we're thinking we're busy now, just wait until this population boom reaches those sort of senior ages. So I want you to start doing a lot of the groundwork today. You know, I want us to really be looking at prevention so much more than what we did last year, let's just say.
We really need to be looking at these pandemic puppies and kittens that we're seeing currently, and really, really hammering home a few sort of messages that hopefully will help us when they do become senior. So when we're seeing these clients, we really need to be talking about nutrition, we need to be talking about body condition scoring, weighing these animals, getting them, . You know, not when we're doing sort of puppy parties, puppy socialisation, we also need to talk to them about regularly weighing their animals and getting them socialised, habitualized to actually sitting on the scales, you know, making sure that owners can weigh their cats at home, all these sort of things, because when it, when they do become senior, it's going to make our life just a little bit easier, I hope.
So what requirements do we have in older pets? Well, It is one of those, it does depend sort of questions, isn't it? It really does depend on what is, what the animal presents in front of you.
I lecture a lot on senior clinics and what to include in senior clinics, and I think we, we as veterinary nurses, we veterinary professionals as a whole, we really need to actually stop pigeonholing these clinics, these consults that we do, and actually make it more about the animal that sat in front of you. So it's very rarely that you'll do an arthritis clinic, and all you talk about is arthritis and mobility. You might also be talking about obesity, you know, making sure that we've, you know, we're at our ideal body condition score and so on.
The requirements for older pets is gonna really depend on what's in front of you, and you know, these are the main things that we, we really do see. So mobility, you know, we know that you've all been told the statistics, haven't you? So 80% of cats over the age of, you know, 7 or 8 will have some arthrotic changes.
Obviously, as they become, let's. Call it geriatrics, so 1213, 1415 years of age, it's almost 90%, you know, nearly hitting that 100% mobility. So, You know, we can sort of, you know, when we're thinking of cats, you know, nearly all cats really, we need to be talking about mobility issues.
Obesity, I'm gonna be talking a little bit more and a little bit more depth looking at energy requirements for senior pets because the new information and new evidence that's there really will make you think about senior diets quite differently. Traditionally, we will always taught cats and dogs as they become older, and they need to have less energy in their foods. That's what we were always told, we know that that is, you know, the evidence has shown differences now.
We do see sensory changes in older pets. We know their sense of smell goes to faster ghost, that really does have differences. As the digestive changes, and again, there's lots more evidence we we're gonna be discussing in a bit more depth about that also.
But major organ system changes is something that, you know, you need to know the full clinical history of that animal that's in front of you. You know, do we need to actually be looking more at a renal diet than a senior diet? Do we need to be looking, you know, what, what are we looking at?
What's our liver function like also? And dental disease is a really big thing. It's some, we all know as dogs and cats get older, the incidence of dental disease does increase, but how does that affect affect nutrition?
Well it might not actually affect what you feed, but it might very much affect how you feed the food. So I have a very newly acquired cavalier spaniel, like you do as a vet nurse, and she has got . You know, heart issues.
She's, she's a cavalier. She only has 5 teeth. So the diet that she's on only comes in a dry formulation.
So thinking about nutrition, you know, we need her on a cardiac diet, but I need to think about soaking that food for her before she can even think about eating it. So we do need to think about these things also. So just going into a little bit more, more depth, sensory changes is a big thing in cats and dogs, especially in dogs, and it's something as as human beings that we tend to forget because our sense smell is important, but it's not as important as it is for a dog.
So as the animal ages, smell is the first sense that does decline. And as that animal's sense of smell deteriorate, they will eat less. They, they just do, we know that.
So the aroma is really, really important and you know this from when You know, you're taught, you know, how to get cats with, with flu to eat more. You need to sort of bathe all the, all the nasal discharges away so they can smell the food so they can eat it. But if that actual sense has deteriorated, we need to make the food more aromatic.
So some food manufacturers do have food that just smells more. They, if they, you know, it's a dry food, dry food doesn't smell as good as wet food if you're a pet. They'll coat the dry food, the kibble in a, in a sort of, a coating that smells more.
Obviously, if you wet the food slightly, that makes it smell more also. So there's lots of different things we need to sort of consider that. We need to remember with cats, cats are cats, aren't they?
They're always a bit fussy, and their dietary preference is based more on the texture of the food and the nutrient composition of the food than it is on the actual, you know, what flavour is it? Is it fish flavoured, chicken flavoured, those sort of things. So by manipulating that, that can also help when when we're looking at cats.
So we need to think, OK, not just what brand we're feeding, what life stage or what veterinary diet we're feeding, but differences between wet and dry when we're looking at senior diets also. I put a little bit about pain scoring systems in here because I think this is really important and it really does get missed off when we're talking about nutrition. If you're in pain, you might not eat as much.
So if we have animals that are, that are inappetent, the veterinary surgeon does need to, you know, do that full clinical exam. Is there something that we're missing? Why are these animals not eating as much?
Are they feeling nauseous because of something else? Are they in pain? And that's why they're not eating?
Is it the case that they can't get to the food as well, because they're always, you know, used to be fed on, on the side in the kitchen, . And they can't jump up on the side anymore, or is it because, you know, they're fed on the other side of the cat flap that they can't get through or, you know, so on and so forth. So pain scoring systems as part of your nutritional assessment is really important.
We know about our five vital assessments, so temperature, pulse, respiration, number 4 is pain, and then number 5 is the nutritional assessment. So we need to be making sure that we are doing these. So we have really good acute pain scoring systems, so the Glasgow Short form composite, we've got cat, we've got dog one, we've got the Colorado, which is that different coloured one in, you know, down in the left hand corner there, and they're very good for acute pain.
But when we're looking at chronic pain, you know, there are different pain scoring systems. So there's the Helsinki, which is the chronic pain index, for dogs. That one tends to be used most of the time.
There's also the load one which is the Liverpool osteoarthritis for dogs, obviously quite specific, but, you know, can be useful. For cats, there is the chew questionnaire, so it's the cat health and well-being questionnaire. And yes, we're looking at quality of life, but I think nutrition is an important aspect of quality of life.
You know, how much do you enjoy food? You know, what if you only got to eat food you didn't like for the rest of your life? How would your quality of life differ?
Some of you, right, yeah, I'm not too bothered. Some of you really like, oh my God, food is everything to me. So it's really difficult to sort of, you know, gauge that in our pets.
There's a nice picture there from the ICA care guys, looking at arthritic elbows. So again, we could do the most amazing nutritional assessment. We could make the best nutritional plan known to man.
But can our cats get to their food? Do we need to look at raising their bowls up slightly so it makes it easier for them? And you know, don't forget our dogs as well, you know, if they've got neck pain or, you know, jaw pain or anything like that, again, what do we need to do, how do we need to adapt the food that we're recommending and the way that we feed it to really help these animals out a little bit more.
So when it comes to dietary advice, we need to make sure that we're doing that nutrition assessment. So, getting the correct diet is important, so we're using a adult diet for an adult, a senior diet for a senior, but we need to make sure we, it's also the correct diet for the body condition score and the muscle condition score of that animal. Overweight animals, you know, we, it, it doesn't matter, you know, what age they are, we need to address that weight loss, even if they are 15 year old Labrador.
And the owner's like, Oh, there's no point, you know, he's at the end of his life. He doesn't do much. We, we know there's been lots of research done, looking at quality of life and weight loss, and just losing 10% of the body weight you need to lose.
So if that Labrador needed to lose 10 kg, just losing 1 kg dramatically alters their quality of life. So it really, really is worth doing. But on the flip side of things, animals with a below normal body condition score also need to be addressed.
We know that animals, when they're below that ideal, actually morbidity and then mortality are actually, you know, quite closely linked. So any animal that has an, unintentional weight loss, so, you know, not being dieted or they've not deliberately increased the exercise up or so on and so forth. In our practise, we have a 10% rule.
So any, unintentional weight loss that's more than 10% has to be referred back to the veterinary surgeon. We obviously preempt what's gonna happen, so we say to the animal, I'm a bit worried, you know, we've lost 10%, you know, that might only be 400 grammes in, in, you know, a 4 kg cat or cat that was 4 kg. You know, the, the vet might want to do blood.
So just make sure we pre-star beforehand, you know, all those sort of things. So we are preempting it a little bit. So obviously for these underweight animals, we need to rule out metabolic disease.
And in cats, we, we, well, I do tend to find a lot of the time that sometimes the senior diet, you know, yes, they are higher in digestibility. We actually might need to go to a, you know, GI diet with really high digestibility because we're seeing so much weight loss. And we know in cats that they find it more difficult to digest their food as they get older.
So we might be looking, going down the route of GI foods. But we need to really regularly weigh and body conditions school these animals regularly. That goes back to the first slide that we looked at today, looking at, just getting owners to weigh their animals regularly, sort of once a month, you know, just put it in their, in their phones, you know, you can get an app that sort of monitors your own weight.
A lot of them, you can, you know, also put your pet in there as well and just monitor their weight also. So what diet are we gonna feed these senior animals? So, you know.
I think owners are so much better now at knowing that there are life stage diets to start with. There's so much better and, you know, you can go into any supermarket and you will see puppy or kitten food, adult food, and senior food in the supermarket. So it's, it's a given that, you know, owners know this.
When to change is is a difficult thing for them. There is no given sort of guidelines of what a senior diet is, so it's And each of these food manufacturers will have slight differences in in what they have. So some of the characteristics of senior life diets that we see a lot of tend to be reduced salt, so lower sodium, lower phosphate.
That's, you know, we see that an awful lot. Increased antioxidants. So you, you and I all know that we should eat, should, should eat 5 portions of fruit and veg every day to get our vitamin and mineral levels and, you know, dietary fibre, all these sort of things.
As we become older, we actually need more antioxidants to battle against those readicals that are associated with with ageing. So when we actually hit geriatrics, so when we hit sort of 70, 80 years of age, the government guideline, well, the guidelines actually hit nearer 15 portions of fruit and veg a day. I struggle with 5, so, you know, going down your supplements route is probably better for you at that sort of point.
But you will see in senior diets, you will see increased antioxidants. Now the next 3 I've question marked and we're gonna talk about the the next 2 in quite a little bit more depth. So protein level changes is something we always talk about in senior diets, and calorie changes is something we always talk about in senior diets as well.
Some senior diets also have biscuit density changes, so the kibbles are softer, probably because, you know, these animals have got periodontal disease or, you know, these sort of things. So again, you know, should we be giving softer kibbles or should we be actually treating the periodontal disease and going from there, you know, it's another question for, for a dentist probably. So let's just look at nutrient requirements and it it's got a lot to go through now, so senior cats.
There's lots of ageing factors of senior cats, and there's lots of studies that have been done, and it has been found, it's been concluded that actually the energy requirements in cats. Does alter as they go through through their lives. And actually, once they reach geriatric stages, the energy requirement when they are geriatric can be as high as when they're kittens.
So traditionally we were told, as you get older, feed less energy. Well, we actually know now that in cats they actually need more energy. So that could be just consuming more calories, or it could be consuming a more energy dense food, those sort of things.
So new diets that are on the market really do differ depending on the viewpoint that the manufacturer has. So you might speak to one food manufacturer and, you know, they'll say one thing. You might speak to another, and they'll say something else.
So the nutrient values really, really will differ depending on the manufacturer. And Both here, still classing us as Europe as in the EU, we have an overriding sort of food body, let's call them, called FEDA, and they set out what requirements are needed for adults, for juniors, for lactation, well paying, and, and senior. And currently on senior, there is no, you know, recommendations.
There is no, this is a senior cat, therefore you should feed it X amount of calories, you know, so much vitamin D, so much calcium. So there there aren't, they, they're not there. And this is because there's such wide variations within that life stage, it really needs to be tailored to the individual that you're seeing in front of you.
So basically, they're saying, you know, you'll see one senior cat at 12, and it'll be very different to the next senior cat that you see at 12. Its energy requirements might be completely and utterly different. It might be half compared to the other.
So you must do your nutritional assessment and feed it depending on what's sat in front of you. So Dogs, dogs are always easier when it comes to nutrition, I find. We know in dogs that their MER, their metabolizable energy requirement, does decrease with age.
So as dogs get older, their energy requirements become less. Now this could be due to they don't move around as much, their mobility might be, you know, there as well. So As they become older, obesity, the prevalence of obesity does increase, and that's normally because people keep feeding the same amount every single day.
So, you know, when the Labrador was 5, it's probably still being fed the same amount of food as when it's 10. But we know the energy requirements decrease, we should actually be decreasing the amount of food, the amount of calories that are going in. And This graph is actually from the life lifespan study that Purina did where they had two groups of dogs.
The dogs were paired, so there was a lean dog and a control dog. The lean dogs were fed 75% of what the control dogs ate, and the dogs that were kept lean lived longer. It's, you know, it's it's one of these things that we, we, we know.
So we know if we can reduce the amount of calories down as these dogs get older, then potentially they will live longer. Dogs are actually really good at maintaining their nutrient absorbative ability. So cats, as they get older, they become Worse, poorer at digesting their food.
Dogs don't, they just carry on digesting, digesting food as they were. So because they carry on as normal, and they're doing really well at digesting their food, but they need less calories and we're still feeding them more, there's no wonder that the obesity prevalence is is increasing as they do get older. So cats, let's look at the MER, so the, the amount of energy they need each day.
And you can see these cats in this graph, you know, from kitten, right the way through to almost 18 years of age. So this kitten, their energy requirements, are, are really quite high as they become older, sort of middle aged, let's call it, it does decrease down. But when they hit around about 11, it does start to go back up.
So There's lots of studies that shown that increased incidence of obesity, you know, up until roughly around sort of 1011, 12 years of age. But after that peak, there then does become a loss of body mass, fat, lean tissue, all of those sort of things do tend to be seen. So it really does emphasise why we need to be doing these nutritional assessments, why we need to be looking at body condition scores and muscle conditions schools.
And again, lots of studies done looking at the speed of decline in body weight, and does that link into mortality? And yes, it does. So if these animals are starting to lose weight, you know, after that 1112 years of age, and you're seeing them in your nurse clinics, we must, you know, refer those actively, you know, promote going back and seeing the vet, you know, getting diagnostics done, you know, why are we losing weight?
It's a really, really good predictor of mortality. The study that was the that was done and presented, in, in 2018, it's number three there on that references, you know, really showed that, if you had that progressive decline in body weight, there was an average of sort of 2 years before, before these animals were. You know, they died, whether they were put to sleep or, you know, those sort of things.
So weighing these animals regularly is really, really important. So get owners to weigh these animals regularly and, and ascertain, you know, where we are. So this is from, CA Professionals, and, you know, I, I love these sort of visual things.
You know, it's lovely me showing, you know, telling you stuff. But when you actually see it, you're like, Oh, yeah, I get it now. You've all seen stage 3 and stage 4.
And when you're seeing these cats every single day, you don't notice it. So, again, making sure owners are weighing their pets regularly at home is really important. You know, any loss in weight.
Again, refer back to the vets. So this is the iris renal scoring system. You all, you all know at Iris, you know, stage one, we've got normal appearance, we've got very little clinical signs.
Stage two, we might be starting to see some, whether owners noticed that or not. Some will. I'm gonna say most won't, but we will have a drop in weight.
We will have a drop in lean muscle mass. Our body condition scores and our muscle condition scores will be starting to change. So it's important that we are monitoring these animals and, and, you know, really getting on top of this.
So the subject that everyone has the most, should we be restricting protein in senior diets? And that's what we were always traditionally taught, weren't we? Senior diets have got lower protein levels.
Whether you're a dog, whether you're a cat, we restrict the protein in senior animals so they don't get renal failure. And actually there's no evidence of that. There's no evidence that restricting protein is beneficial.
Actually restricting protein can be more harmful in, older animals than it can be restricting protein during growth phase in animals. So it's really important that, again, I'm going to keep going banging this on, that we do our nutritional assessments, that we're doing our muscle condition scores and monitoring that lean muscle mass. So, again, lots and lots of work done looking at this, and we know that protein requirements actually increase in senior life stage compared to adults.
Now, this is due to, reduced protein synthesis, so we're not producing as much protein, you know, we're just not doing it as much as we wish we were during adulthood, and we've got a higher protein turnover as well. So, If you imagine, you know, we've got less protein potentially in our food. We're turning it over quicker.
We're not making as much from the nutrients that are coming in. If you're a cat, you're not digesting it as well, then that really just compounds the problem, and then we really, really start losing lean muscle mass quite quickly. So there is an argument that these, you know, cats, especially because of that impaired digestive ability, need a higher protein, you know, content in their food.
There is, you need to remember a difference between quality and quantity of protein, so you can keep the protein levels the same, but if you have a better quality protein with higher digestibility, that might be, you know, just as good. So something else I just wanted to touch on, this is from a really, really good paper that was in Companion Animal in 2019, really just looking at senior diets. And there is a big difference between cachexia and sarcopenia.
So sarcopenia is loss of that muscle mass due to that ageing process. And if you think of You know, imagine you, you know, walked into an an old people's nursing home. You're not gonna see anyone, you know, any of the residents there that are massive bodybuilders, are you, with great big, you know, muscles and everywhere because the ageing process.
You will get a decrease in muscle mass. So, sarcopenia, is a form of low, low grade chronic inflammation, where we get reduced muscle mass, we get reduced strength, you do become weaker as you become older, and the muscles don't contract as well. So it's important that, and we're always actually told this as well as humans, that actually doing some form of, actual weight lifting.
As you become older, actually really helps reduce the incidence of sarcopenia. Anything that dampens down that chronic inflammation also does help. But we know when we get lots and lots of lean muscle mass decrease, it increases our morbidity and therefore increases our mortality.
So we do see lots of chronic diseases as well, so heart problems, renal issues, cancer as well, where we get chexia, and you get really high levels of inflammation, you get the same issue occurring also. So muscle condition scoring, this is from the WSAVA website and it goes into huge amounts of detail about how to muscle condition score. And you can, you know, again, visually it's gonna be a lot easier to to look at these pictures and listen to me talking.
You know, we need to sort of just monitor, the muscle condition of these animals and you can even do this in obese pets as well. Because the muscles that they're asking you to palpate, so, just above sort of the eye here on the top of the head as well, sort of shoulder as well, . Even in dogs and in cats, even when they're really, really obese, you can still palpate these areas.
So it's something that we really need to be looking at in our senior pets. So something that we found that can be really, really useful for senior animals is our omega 3 fatty acids. Omega 3 fatty acids are the most amazing nutrients for a nutritionist out there because they do so many amazing things.
So we know in diets that have, or even, you know, animals that are, have increased their omega-3 fatty acid intake, whether that's through supplements or whether it's that encompassed within the diet, actually have better muscle condition scores. We know that omega-3 fatty acids help improve muscle function, so the strength and the contractability, the endurance of the muscle, and therefore help to minimise sarcopenia. And that's a little bit down to .
You know, we're feeding these fatty acids, they can also be used as energy. So there's less protein breakdown to make energy, but also they are reduce inflammation. They help with, you know, damp down those inflammatory mediators.
That may be involved with sarcopenia and cacaxia, you know, we're saying that, you know, we have that chronic, inflammation system going on. So EPA and DHA help dampen down that inflammation and therefore that can be, you know, also useful. And there's also lots and lots of evidence out there now looking at how these fatty acids can be beneficial when we have osteoarthritis, degenerative joint disease, you know, whichever acronym you'd like to use, you know, still the same thing when it comes to, you know, the pets in front of us, you know, it's pain, it's, and, you know, affecting their mobility.
We know omega-3 fatty acids really do help with that. So for these animals, you know, We're helping them with their mobility, they're able to move around a little bit more, they're able to exercise a bit more. Again, that's gonna help with their lean, you know, body mass also.
So in, in the UK and the EU as well, manufacturers are not required to declare the concentrations of these nutrients. So sometimes it can be difficult to know how, how much fatty acids and the specific EPA's and DHAs that are in the diet. And also there's no.
Standardised dose. So you know, if you're giving an NSAID, you know what the dose rate is. There isn't that dose rate that's, you know, that we know for EPA and DHA that is, you know, the, I can't really.
Therapeutic is not the right word because it's not a medicine, but I'm sure you know, you know what I mean. We don't have that standardised dose so it can be difficult. So digestibility, I've talked about this a little bit and just a little bit more in depth because digestibility of the food is really, really important because you could have a food that has, you know, increased amount of protein in it for the cat, or, you know, loads more omega-3 fatty acids in it to help, or it could have, you know, lots of other different things.
But if the animal isn't able to digest it, they're not gonna get those nutrients out of the food. And again, cats and dogs are completely different, so we need to treat them differently when it comes to senior diets. The cats show a negative correlation between age and protein digestibility.
So 1/5 of cats over the age of 14, so the geriatric 50% of all geriatric cats have a reduction in protein digestibility down to 77%, so they're only able to digest 3/4 of the protein you're feeding them. So you can see now why if we've reduced the amount of protein in the food because that's what we, you know, some manufacturers do in their senior diets. We've reduced the amount of protein down, and our cats are only able to digest 75% of it.
And maybe they're not eating as much because they've got arthritic elbows. You can see where they're actually starting to become protein deficient in their, in their diets. And we're, you know, we're just exacerbating that sort of, you know, feedback mechanism of all that sarcopenia and everything else.
So this is why the amount of protein is in their foods is really, really important. Just to compound the problem if you're a cat as well. That digestibility is also significantly reduced in cats.
So approximately 10 to 15% of cats aged 8 to 12, that's a senior sort of category. And then 30% of cats when they get that into. Let's call it the senior geriatric category, have really, really marked impairments in their fat, fat digestibility, so.
They're not digesting the, the protein that you're feeding them. They're really not digesting the fat that you're, you know, you're giving them as well. So, and they're not eating as much at all.
So it's, it can be really difficult. So we really need this almost super concentrated food if they're not eating as much. So even if they're only, you know, eat the same volume, they're taking in a more concentrated food.
The other thing to remember if we're not eating as much or we're not able to digest as much fat. Fat just isn't fat. It also contains all the fat soluble vitamins.
So things like vitamin A, so A, D, E, and K are your fat soluble vitamins, they're not gonna be taking those in, they're not gonna be taking them on, on board. Vitamin E is a really, really important antioxidant in the ageing process, so we need lots of vitamin E on board with the with these cats. In turn, that affects the amount of vitamin B levels that are on board, and we know vitamin B12 especially is really, really important for appetite stimulant in these cats.
And you've also got all those minerals all bound up as well sometimes, so you really need to be really careful that these animals don't start becoming deficient in certain nutrients. Like I said, the, this drop in digestibility hasn't been demonstrated in dogs, so, you know, we're really, you know, lucky in that respect. It's, it's, you know, it is just cats, but we need to treat them slightly differently when it comes to their senior diets.
There's something that's really, really The thing we have in nutrition is we get fashions. Things become fashionable, don't they? I'm gonna say 15 years ago, omega-3 fatty acids were the, the fashionable thing.
I'm gonna say now it's medium chain triglycerides or MCTs, the, the nutrient of, of choice at the moment. So many senior diets, you know, our premium senior diets, go and have a look, go and have a look at the packaging and you'll see a lot of them are supplemented in medium train triglycerides. Now, these They're, they're fat, but they're, obviously, medium length.
They're a subgroup of fats that when they're digested in the liver, when they're metabolised, you know, deaminated, transaminated, you know, all those sort of different things that the proteins are as well. The, fats are also broken down, and the fats are broken down. Also, they're broken down into ketone bodies.
Now these ketone bodies slightly different than a little bit different to the sort of, you know, don't worry about the diabetes sort of things, these animals aren't diabetic. But these ketone bodies are actually the energy source of choice for brain cells. So they're used a lot in senior diets because one of the things we're really concerned about when we become older is our cognitive function.
So these Diets supplemented with medium chain triglycerides, and they've, again, lots and lots of studies that have shown these MCTs really help improve cognitive function in older dogs. Now they've not been able, always it's my study just made me giggle. There was lots of comments, but they couldn't demonstrate this in cats.
They have no studies looking at cats because they didn't know whether the cat was actually cognitive better or just ignoring them. So you can, you can imagine, you know, you're trying to do behavioural studies, the dogs, they found the ones that supplement, they could treat, you know, train them to do new things. They could teach them new tricks, they could, you know, show them things and, and they learn a lot better when they're on these supplemented diets.
Again, the cats just sort of sat there and ignored them, so they have, they don't have any evidence to show whether this, this works in cats also. The MCTs, this, this study was done in 2010, and they fed a diet to dogs with a blend of 5.5% MCTs, and again, the improvements in trainability, they learned these new tasks, but also those cognitive dysfunction things that we look for quite often, interactivity with others, they were just more interested in playing, there was improvements in alertness.
There's lots of different things compared to that that control group. And it's thought that these ketone bodies really help improve the functioning of the mitochondria, and, you know, all these sort of other things. So these MCTs, are, are basically found in coconut oils.
So, I know, I know all of you will probably have a client or two that adds coconut oil to. To their, their pet food, very much the same as, you know, adding cod liver oil to the pet food. Well, yes, cod liver oil does contain EPA and DHA, but not in the concentration, you know, enough to actually help with arthritis.
Coconut oil, again, yes, it does contain MCTs, but not in enough concentration to help with cognitive function. You need a more refined and, you know, more, more of it of of those MCTs, so. You can get, you know, diets with these in, you can get supplements as well, but MCTs really, really do help.
So when we're looking at nutrition, it's really important to, you know, when we're talking about diet transitions to recommend longer. Older animals tend to be more neophobic, so Neo is new, they're more phobic of new things than younger animals, especially cats. So transitioning, we need to do a lot longer, and it might be the fact that we need to do intermediate sort of transitions also.
I'm sure all of us know about, you know, putting a cat onto a renal diet that's only been fed adult food. We would normally go adult. Senior maybe, and then renal, so we're doing little baby steps as we transition rather than, you know, great big jumps.
So diet transitions, you know, don't do 3 to 4 days, do 1 to 2 weeks, you know, give them a little bit longer to, you know, we, we don't like change as we get older. I think cats and dogs are, are just the same. So feeding behaviours, you know, especially with our dogs, where we know obesity is more prevalent as we get older, you know, looking at feeding behaviours, you know, looking at, you know, getting them to forage for their food a little bit more, you know, environmental enrichment is, is as important, you know, how the food is delivered is really important for dogs and cats and don't just think of it as, you know.
You know, from an obesity point of view, think of it from a cognitive function point of view. You know, we, we're always told to do more, you know, brain teaser puzzles, more sudoku, those sort of things as we get older, just to keep our cognitive, you know, function going. I think they're the same with dogs and cats, so puzzle feeders, those sort of things really do help.
They have a really positive effect on the quality of the life of the animal as well. So how we feed is as important as what we feed, and we really need to be building that into our nurse clinics as part of that nutritional assessment. So increasing both the physical and the mental exercise, you know, we can do that.
That's gonna help with our sarcopenia, that's gonna help with the cognitive function. That's gonna help with, you know, obesity, weight loss, those sort of things in, in our dogs also. So there's loads of puzzle feeders out there.
There's commercially available ones. You can, you know, collect all your toilet rolls up and, you know, make them, you know, do Blue Peter and, you know, make something at home. It's really, really easy to do.
The cognitive function, again, use those puzzle feeders, but if we have a deterioration in our cognitive function. You might need to do even longer transition times for our senior diets. Also look at the routine.
Routine's really important. We know this in people, and feeding times is an important aspect of that. So, you know, don't forget how important food is in routines for dogs and cats that have, you know, cognitive dys you know, dysfunction.
So something, you know, if we're looking at sort of all the different nutrients aspects of our senior diets, if we look at our salts, you know, our sodium, or phosphate, it's really, really important. And, you know, those, if you remember the beginning of this talk, you know, those are my only ones that didn't have question marks next to them. There's loads of evidence looking at sort of salts and phosphate and sodium and, and so on.
And this is the ACVIM, which is the American College of Veterinary Internal Medicine, . They have lots of consensus statements, which is, a bit like a knowledge summary or, you know, like ISFM do their guidelines on certain things. It's very, very similar to that.
This is on a mitral valve disease in dogs, and, you know, they've got a lovely classification, a bit like the iris staging for kidneys. Think of that, this is the, the, the hearts, the staging sort of system. And The reason I'm showing you this is, because if we, we know how much sodium needs to be restricted for all these different stages.
So A on their staging system, so there's your predisposed breeds. So Cavalier would definitely go in there. That's an easy one.
So I know with Mike Cavalier, she's a B2, she has a heart murmur, she's been scanned. She has cardiac remodelling. So, you know, she's on a Pimabendin.
She's a little bit hypertensive, so she's on some amlodipine. And again, we know that, certain like MCTs can really, really help with our heart cells as well. So she's on a cardiac diet as well.
So by staging these things, we know what elements to sort of feed, and it's the same with the iris system as well for renal failure, we know how much phosphate that, you know, needs to be controlled. So sodium levels, you know, we, we have these recommendations and. Again, that cardiac, that classification Ace, that's your predisposed breeds, so all your cavaliers, but also I would be popping all my senior pets in there.
So my senior pets are more likely to have heart problems than our young pets are. So their dietary sodium recommendation is really, you know, just advising owners about not feeding high sodium treats and, you know, You know, stop feeding them, you know, the sandwich meat the thing, you know, crisps, those sort of things. High sodium, what they class that as is 100 milligrammes of sodium per 100 calories of food.
So again, you'll find that on the packaging and the different cardiac classifications have different sodium contents there, so you can, it's a bit outside the scope of this talk, but it, it is there. So we know what our sodium recommendations are. We know as we become older, it does need to be restricted in our diet.
Phosphate, again, another one that we know. As we become older, we need to be a little bit more careful about, you know, the amount of phosphate that, that we're eating, you know, the salt that we're eating. And Waltham did a, a big, big review looking at this, and they actually .
There is an upper and lower amount of phosphate that should be in cat and dog diets. They looked at cats because it tends to be cats that we do look out for this more than anything. They did recommend that the upper level needed to be reduced down because there was a potential that it might contribute to chronic kidney disease.
So they're the amounts that they recommended. You've got to remember though that phosphate needs to be done in ratio with the calcium, so we're reducing one down, we do the other, and so on. We also need to remember that not all phosphate salts are the same.
There are, it really does depend on on what the manufacturer uses in there. So it's important that. You know, we ask these questions of the manufacturers that they are using the right sort of things.
But there's really, really little data that's out there. But it is something that we know that we should be, you know, reducing down as we become older. And obviously, you know, there are, we know this in renal cats as well, things like phosphate binders and so on that can really help with these aspects.
So I'm gonna start, I'm gonna finish really where I started and basically say prevention is better than cure. If we can help reduce, prevent obesity in our dogs as they become older, that's really gonna help us, isn't it? If we can reduce, you know, or we can identify, we can highlight these cats that are starting to lose weight once they've gone over that, that 11 years of age hump, again, refer them back to the veterinary surgeon.
Make sure your vets also know why you're referring them, you know, back to, to them, . You know, monitoring these cats, these dogs closely as, you know, they become senior, we can help prevent, you know, or catch things a lot earlier. So puppy kitten clinics, ironically, is a really a place where we want to get this on board to clients.
We need to, you know, build up that loyalty. We need to tell owners about why we need to weigh them monthly, you know, get them to keep a diary or what whatever it is that they want to do. Again, discuss, you know, not just baseline blood parameters, but blood pressure parameters.
I know when I took my, my dog to, to see the heartbeats, they were like, there's an app you can get, and I want you to monitor sleeping, respiratory rates. So I, we know, a normal, so that we know what's not normal. I, oh, that's amazing.
So again, all of these baselines, you know, we're really, really good, aren't we, at talking about pre-anesthetic bloods and using those as baselines, but there's lots of other things that we can be using that really, really will help these senior animals and help us from a nutrition point of view. So thank you so much for listening. I'm gonna hand you back to Bruce.
To help with the questions. So thank you, everyone. That was absolutely fascinating, Nicola.
Thank you so much for your time and your insight. It's it's always good to have these things wrapped up in a nice neat bundle, you know, rather than how we think about them sometimes during our day, where it's a bit of this and a bit of that. So thank you for sharing your knowledge and expertise with us.
There are a couple of questions that have come through. The first one is more a question about information, and, Hillel wants to know, have you got or do you recommend any tables that contain puppy and adult and senior nutritional requirement values? Well, there are some, and they're argued over more than anything else.
So the NRC Years and years and years ago now, produced, what I'm gonna call it a document, but it is more a book, looking at what the minimums and maximums for all these different, you know, vitamin D, vitamin E, protein, fats are for all these different life stages. And I'm gonna say every nutrition conference I go to, they are argued and discussed and, you know, someone's found some evidence that they aren't quite right. And so yeah, there are some out there.
The National Research Council, Nutritional Research Council, produced this book. There's lots and lots, if you just Google it, there's loads that come up, so different editions that come up. I mean, so that, yeah, there are out there, but it is a massive document.
Yeah, and I, I think the, the thing for me there is what you were saying earlier about, it's a very individualised situation, you know, so, I mean, even the, the sort of controlling bodies and regulatory bodies haven't got these specific things because especially when it comes to our senior babies, they, they are so different. Mm, yeah. I think, I think you just hit the, you know, the nail on the head there.
We need to You know, look at what's in front of you. You know, is it a, a 10 year old, you know, springer spaniel that is absolutely full of life and, you know, doing miles and miles and it's still working, or is it like, you know, little 10 year old cavalier that's, you know, just going around the block each day and it isn't doing much exercise and it is overweight and, you know, it needs to lose weight. It's each individual is, is so important that you have a nutritional assessment for every single one.
I was just about to say exactly the same thing. I think it's a combination of, of let the vet evaluate the overall health. We know that senior pets, there's some fantastic screening tests, blood tests, urine tests that can be done.
There's companies like our sponsors tonight, Royal Canon, that have got these fantastic products and guidance systems involved. And then let your, your practise set up a a combination between the vets assessing what's going on and then the nurse who, let's be honest, are way better at this than us vets are. And they, they let them take on this guidance role in helping people because it's, it's not just we'll go home and do ABC.
It's an ongoing process. I love what you said about weighing the pets and that, because it really is, it's a, it's a About us an overall assessment, and I, I think our vet nurse, profession is in an absolutely fantastic position to do that, for our patients. So, that would be my advice.
I, I, I think you would probably agree with that. Yes, yes, definitely. It's, it's the veterinary team that looks after the pet.
It's not just the vets, not just the nurses. It's, it's all of us together, you know, working towards, you know, increasing that, those clinical outcomes for that patient, really. Yeah, yeah.
It's it is a very fascinating field. And I, I personally love geriatrics. I've, I've always been fascinated by them.
And, a, a very dear friend of mine who's also a vet, always says to me, you're crazy, cause you can never solve anything. You know, and I said, yes, but You can make a massive difference to the quality of life. And that's what it's about at the end of the day.
It's not about curing, it's about helping and benefiting so that, you know, the, the second half of life is comfortable and happy rather than a dread and a strain. Yeah, definitely. Yeah, fantastic.
Nicola, I'm not going to open up some of the boxes of cans of worms and some of the questions that have come through, because they will take whole webinars to talk about. We do have some webinars that we've already addressed some of these issues. So I think what I'd like to do.
At this stage is, once again, thank you so much for your input and sharing your knowledge with us tonight. And I'm going to ask Dawn to share her screen. And, folks, as I have mentioned a few times, we are very pleased tonight to be sponsored by Royal Cannon.
And, it is thanks to them that we were able to open up what is usually a, a member's night on a Thursday. And we just have a little promo video, from our sponsors, about a really exciting, let's call it a product, shall we? Dawn, are you ready to share for us?
Chronic kidney disease, or CKD is very common inside a cat. An estimated 30% of the feline population over 10 is affected. The earlier the diagnosis of CKD, the earlier we can intervene medically and nutritionally to better maintain quality of life.
Unfortunately, because cats show clinical signs very late in the process of the disease, when 75% of the nephrine are already affected, it is very difficult to identify early. At Royal Cannon, with veterinary nephrologist of the Royal Vet College in London, we ask ourselves, how can we help practitioner to identify those cated risk of CKD as early as possible. We retrieve historical data from over 3500 cats collected before and after a diagnosis of CKD totaling more than 10,000 consultations.
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If at risk, a catch should be followed closely with regular kidney panels with creatinine, SDMA, and urines specific gravis. And as a precautionary measure, we also recommend a diet moderately restricted in phosphorus and enrich in omega 3 fatty acid and antioxidant. Identifying patients at risk of sick early allows better management and maintenance of quality of life, as well as honour reassurance.
Developed by veterinarians, for veterinarians, Mineral detect helps achieve health your life for our senior cats.
