VC2023 Nutrition Evening | Veterinary Videos & Podcasts

Good evening, everybody, and welcome to this Tuesday evening session of our 11th virtual congress. And a huge big thank you to Royal Cannon for their sponsorship tonight. Without them, this would not be possible.

So, thank you, Royal Cannon. Little bit of housekeeping. For those of you that are unfamiliar with webinars, if you want to ask any questions, please just move your mouse over the screen.

The control bar will open up. You'll see normally it's a black bar down the bottom. Click on the Q&A box and type your questions in there, and we will hold those over to the end of the session.

Tonight's session is being chaired or being, presented by Georgia Woods Lee, who qualified as a veterinary nurse in 2004 from Meyersop College in Preston. After working in mixed practise, a multi-disciplinary referral centre, and a busy out of hours ECC hospital. In 2010, Georgia was appointed as head nurse and clinical coach for a small animal practise in Cheshire.

In June of 2015, Georgia took the position of Royal Canon Weight Management clinical nurse at the University of Liverpool, Small Animal Teaching Hospital, where she is now dealing exclusively with pet obesity care and nutrition. In addition to running the clinic, Georgia assists with the research the clinic undertakes and has provided education to vets and nurses throughout many countries around the world. Georgia gained her certificate in canine and feline veterinary health nutrition in 2017.

And the animal, veterinary technician specialist in nutrition certificate in 2019, which makes her one of only 25 people who hold this accreditation. She went on to achieve her BSC honours in veterinary nursing, a top-up degree in 2012. So Georgia is more than qualified to talk to us tonight.

And Georgia, welcome back to the webinar, vet, and it's over to you. Thank you so much, and thank you to everyone for joining this evening. I'm hugely excited to be back, and talking about this really relevant topic.

So, in this session, we're going to be thinking about alternative diets, the good, the bad, and the sometimes ugly. So I firstly wanted to define what I'm talking about. What do I mean when I'm talking about an alternative diet?

Well then think within each diet, well, what are the benefits of that diet, and where are the evidence for those benefits? And then we're going to balance them against the risks, so we're also gonna think about the specific risks with these different types of alternative diet. At the end then, I wanted to think about, well, given the risks, why do some owners choose to feed these diets?

I think it's important to have a good understanding of those reasons. And finally, we know that many pet owners are choosing these types of diets, and these are growing in popularity hugely at the moment. So given that the owners are making these choices, how do we support them in their choice?

It is not our job to persuade them or to dictate to them what they should feed their pets. What it is our job to do though, however, is to provide information and education to allow them to make an informed decision. So just to kind of get us going, and I really want to, you know, highlight the importance of this topic.

You know as well as I do, I think, if you walk into a pub and you really want to start a fight, you sit at the bar and you ask, OK, so what do you feed your pet? And you can imagine the sorts of responses that you're going to get to that. There's going to be really divided opinion, and we know particularly with this topic, there is huge divides in opinion, and we also know that those views are very strongly held and often very strongly voiced.

So what I wanted to talk about today as veterinary professionals is how we go about having these conversations, making recommendations and giving advice that is always based on the available evidence. And I say available evidence because there are lots of things that we still don't know. And this talk in 5 or 10 years' time might look quite different.

So, but for now, I wanted to talk about what's available to us, what do we know right now? Now speaking of evidence, I wanted to briefly summarise this chart here. You've all seen this evidence pyramid before, I would guess.

So what we have here is different types of evidence from systematic review and randomised control studies at the top and expert opinion and anecdotal experience at the bottom. Now whenever we're thinking about a piece of evidence, we should be questioning, OK, what is the risk of bias with this piece of information? How is the person who's delivering this piece of information influencing that information to us?

We should also alongside that, think about the quality of that evidence and how reliable that evidence is for us. So when we think of the risk of bias, we've got the lowest risk at the top of our pyramid for our systematic reviews and randomised control studies, and therefore our highest risk of bias down in our anecdotal evidence or potentially expert opinion. That goes hand in hand with the quality of evidence, which is sort of flipped.

So we have our highest quality of evidence at the top because it's subject to the lowest amount of bias and so on. So at the bottom of this pyramid, we have the lowest quality of evidence. So if somebody is presenting you with a piece of evidence, always ask what is the risk of bias and how good quality is that evidence?

So let's define the diets that we're going to be speaking about this evening. What are the alternative diets that I'm going to be referring to? Well, it will come as no surprise.

I'm very sure that I am going to be talking about raw meat-based diets. So these of course are going to be comprised of uncooked meats, potentially bones, vegetables, and then some uncooked nuts, seeds, eggs and milk also. Now raw meat-based diets come in a variety of preparations.

We see them being freshly made, we know that they can also come in frozen packs. They may follow a prey model, so this is where whole carcasses are fed. We then of course have the homemade versions of these diets, and we also have manufactured versions of these diets.

The next type of diet I'll be discussing a home prepared cooked diets, so very similar ingredients, however, these ingredients are now going to be cooked, except for the exception of some maybe nuts and seeds, and these may or may not include some cereals. Most of. These ingredients for both of these diets, if the owners are creating them at home, are going to be sourced from supermarkets.

And particularly with a home prepared cook diet, we won't see any commercial foods that are made, for pets being fed. So these are always going to be a fresh diet. Then I'm going to touch on vegan diets, so these, as the name suggests, are going to be meat-free diets that are going to be plant-based, so all ingredients come from a plant source.

And again, we can have homemade versions or manufactured versions of these diets. And finally, I wanted to touch on grain-free diets. Now, most of you probably don't consider grain-free diets to be an alternative because they are so mainstream, but they fit into this category because as you will see, there are some benefits, but there are also some risks that we need to be aware of.

So a grain-free diet, as the name suggests, doesn't contain grains, and that also can be a home prepared cooked diet, or it could be a manufactured diet too. So let's get going. We'll start with raw meat based diets and what I want to think about first is, well, what are the benefits of a raw meat based diet?

Where is the evidence? So the way that I wanted to structure these next few sections is to think about the claims that are made and then counter that with what evidence do we have for that claim. And there are many, many claims made about all these types of diet.

One of the most popular claims with this type of diet is that it is more appropriate for cats and dogs, and that pets should be fed as their ancestors would have eaten. Now, in evidence as far as whether this is correct or not, one thing that we should consider is where our dogs have come from. So both dogs and wolves were in fact descended from the ancient wolf, which is now extinct.

And through tens of thousands of years of domestication, we've got all our domestic dog breeds and we have got our modern wolf. So our domestic dogs are not directly related to the modern day wolf that we know. They both have a common ancestor instead.

So when we think about the claim that it is more more appropriate for dogs and cats to eat as their ancestors did, we actually don't have any evidence that of superiority, with those diets on that basis. And the claim that pets should be fed as their ancestors were, again, we have no supporting claim for that. What we should consider in addition to that, is the degree of domestication and evolution that has gone on for our dog breeds.

We know our brachycephalic breeds, for example, or our chihuahuas are so far removed from anything that looks like a wolf, a wolf. Evolution has been vast in as far as our domestic dog breeds have gone. We also now know that there are 36 genomic differences between dogs and wolves, and in fact 10 of those differences are responsible for carbohydrate digestion.

And this is because as part of that domestication process, dogs had to adapt to live near humans and humans ate a lot of the carbohydrates, so now we have genomic differences in the ability to digest carbohydrates, which wolves do not. We also know that cats can digest carbohydrates just to a lesser extent than dogs. And we finally know that wolves have a much shorter lifespan than our domestic dogs can enjoy.

Partly that of course is the lack of veterinary care, but it is also partly due to their nutrition. OK, so what other benefits do we have claimed, so we have the claim that a raw meat diet is a more natural type of food. Well, firstly, there is no official definition of the term natural.

It is used an awful lot in marketing, but it is not regulated, and there is no definition beyond saying that, most of that food should come from a natural source. If you take that definition of natural, pretty much every pet food out there could be considered natural, but I'm not quite sure that's what this claim particularly means. But natural is not really, a technical term.

All right, what about things like reduced signs of GI problems? Well, we have no supporting evidence for that. Improved stools because raw meat-based diets are claimed not to contain fillers in inverted commas.

Again, we have no supporting evidence, better breath, no, no evidence for that, and lowered risk of obesity, and I certainly can attest. That it doesn't exclude dogs and cats from obesity, and in fact, we have no evidence to suggest that a raw meat based diet, does actually do that. What about these things?

Less shedding, fewer allergies, better behaviour, fewer parasites, and lower veterinary costs. Well, as you might have guessed, we have no supporting evidence for any of those claims. What about the a raw meat based diet can improve the dentition?

Well, this is in fact somewhere where we do know that we see benefits. So there is some small evidence that chewing bones does benefit the dentition. But, and it's.

A very important but because when we see or when dogs are given bones such as this, we get risks of dental fractures, we get risks of esophageal obstructions, and we get risks of gastric foreign bodies. So even though we might get small benefits from chewing of bones in particular, there are many safer things that we can get dogs to chew, and we know dogs do have an innate need to chew. It doesn't have to be a raw meat bone to get some sort of benefits.

So although there is a small benefit here, I, for me personally, it is far outweighed by the risks of feeding these types of bone. OK, what about improved digestibility with a raw meat product? Again, we do have some evidence actually that a raw meat based diet does have improved digestibility but only when compared to dry foods.

It is, it is comparable to wet foods. So if you wanted something more digestible than a dry food, well, you can simply feed it a tinned wet food instead. What about palatability, you know, palatability is something that owners talk about a lot, and there is some good evidence that it is pretty palatable.

This is because raw meat-based diets are typically high in fat and moisture, and for picky eaters, that could be really good to be highly palatable. However, that's not ideal for any pet that's prone to obesity. We don't want to artificially encourage them to overconsume food, so palatability is a bit of a double edged sword.

What about improved coat quality? Yes, again, we have some evidence, again, it's due to the high fat levels in these types of diets, and again that does improve coat quality, however, not appropriate for those that are prone to obesity. So some small benefits here, but we've always got a caveat, that we could, that we should think about.

OK. So sticking with raw meat-based diets, well, what are the risks of feeding these diets? Well, as you probably are well aware, pathogenic infection is the one that's top of our list.

All of these types of pathogens, including some, parasites, have been found in raw meat-based diets, whether they've been commercially produced or homemade. These are the things that Frequently are found. We should also recognise that it's not just, foods that are meant for meals.

It is also treats that are a problem, as this very recent study just from, January this year, highlighted very nicely the risk of salmonella with some raw, with some raw dog treats. So being really careful about pathogenic infection is probably my predominant concern. And especially in terms of the close contact relationship that pet owners have with their pets, we all know that pet owners do this, but if they are carrying a pathogen that they've potentially picked up from their food, they may be shedding that pathogen into the environment asymptomatically.

It doesn't mean they have to be sick to be spreading that pathogen around either in their urine, their faeces, or saliva. And that secondarily puts other dogs and other people at risk. Whether it's at the park or somebody comes to visit.

So it's something that we really must be very aware of. We have proven cases of pathogenic infection that have been linked to the pet's food, and that has resulted in anything from digestive disturbance to death. There was a case of a small boy who died, from salmonella, and that salmonella was traced back to the, to the dog's food.

So we do have these cases, and of course, they are extremely worrying. The fact that this is happening is largely because of the place that these meats are coming from, and often it's because these foods are intended to be cooked. The FSA, the Food Standard Agency, fully accepts that supermarket chicken will contain some salmonella, somewhere between 4 and 10%.

But we are meant to be cooking that chicken, eradicating the salmonella, whereas this is being fed to pets, uncooked, then we then put them and us at risk. OK. So when we think about the pathogenic risk, what is often talked about is trying to mitigate those risks, and yes, wherever we can, we should try and mitigate them.

So correct storing and freezing is extremely important, following the instructions, getting the temperatures right, and of course hand hygiene. However, we really should note that freezing alone is not enough to kill all pathogens. Camp Pylobacter, yes, we can reduce that with freezing, but many other pathogens just go into a fixed state.

And as that food defrosts. Kind of all have a bit of a party and they multiply even faster than they would have done if they were at room temperature already. So don't be don't be sort of fooled by people telling you that it's fine because the food is frozen, it probably does still carry pathogens.

We also need to be careful when we're defrosting foods, so this should be done, in a fridge, hopefully a separate fridge. We don't want contamination of other foods. If owners are trying to throw away any of the tha water, we must, encourage them not to, because that actually contains lots of nutrients.

And again, hand washing if we're defrosting foods. And then the preparation area, thinking about separate areas, separate utensils, strict hand washing and cleaning of all areas. And again, we have a problem here because people will say, yes, I washer, I'm very strict on hygiene.

And yet this study showed very clearly that normal hand washing, so as it states here, this quote, standards, methods of cleaning and disinfection were minimally effective at eliminating salmonella. So, you can't essentially get rid of salmonella from just washing your, dog bowls or cat. Bowls in hot soapy water.

It doesn't make it any better if you're putting it in a dishwasher. It is very, very difficult to eradicate all pathogens from bowls. So, again, being really careful, yes, strict hygiene is very important, but we don't want to over-egg this.

There will still be a potential risk. OK, what that means is specifically for at risk pet owners is they've really got to avoid touching this food, touching the preparation areas to keep themselves safe, because otherwise they will be at risk, no matter how much hand washing they're doing. All right, so the next thing that we're particularly worried about with these diets is nutritional imbalance, and particularly enduring growth, this is going to be a big problem that can cause lifelong effects if we're not careful.

Ideally, we want all diets to be complete and balanced. That's how we get optimal health for our cats and dogs. And so if the diet has been designed and overseen by a suitably qualified person, then potentially it could be complete and balanced.

But it has to be with somebody with one of these three qualifications that does that. Not anybody, can do it, and certainly there are many people who call themselves nutritionists who have absolutely no qualifications whatsoever. Now the argument against this is that raw meat based diets, particularly if they're homemade, provide nutritional adequacy over a number of days.

That's why the diet is varied. We should also consider alongside that that if we are using a commercial product, it might well be labelled as complete and balanced. But the only way to determine complete and balanced nutrition and nutritional adequacy is via feeding trials.

And to my knowledge, there are no feeding trials that have been done on raw meat-based diets. Most of them will be marked against a laboratory analysis. And so really we just don't have enough information to say for sure that this is going to give us complete and balanced nutrition, so one certainly to be very careful of.

But what do pet owners think? Because clearly, many of them are, feeding these diets. And so this particular survey that you can see, down at the bottom, asked these questions, and the majority said that they had no problems feeding these diets.

There were no signs of, malnutrition in the most part, and the incidence of pathogenic infection appeared very low. However, the study did note that it wasn't, so it's not negligible. So there is still that we must be, careful of.

Essentially, we just don't have enough information yet. We need those properly controlled feeding trials to be able to be sure that we've got diets that are complete and balanced. And of course, that's going to take, further studies on which we would all welcome that evidence.

So we've got a lot to get through this evening, so moving swiftly on, I'm going to be now thinking about home prepared cook diets. So what are the benefits of these? So these, just to remind you, are ones that owners are probably going to source from supermarkets, the ingredients and cook them at home.

So again, we have claims that these diets are more natural. Again, we have no definition of what actually natural means. Our next claim is that we see fewer allergies, with these types of diets.

We don't really have any supporting evidence for that. And in fact, a true allergy, which is, defined as an immune-mediated hypersensitivity to an allergen, is very, very rare, and certainly feeding a home prepared diet does not guard against it. Lower incidence of GI signs, again, no supporting evidence for that, better stool quality, maybe for some individuals, but we have no overall overall evidence improved behaviour, again, no supporting evidence.

What about the fact that we can have a diet with no carbohydrates? Well, yes, we could, but only if this is really necessary, and as we've already said, dogs and cats can perfectly well digest carbohydrates and use them as a source of nutrients. What about that these diets are unprocessed and this is merely the mainstay of wanting to home cook for your dog or cat, it's because you don't like processed foods.

Well, again, this is true, but actually we don't know, and we have no evidence that processing is inherently bad. There are some concerns that ultra processed, foods are causing certain cancers in humans. However, no pet foods could be considered ultra processed compared to the ones, that, that were being talked about in studies that look at ultra processed foods.

So highly unlikely that the processing that pet food goes to is causing any problems at all. OK, our next claim, no additives and preservatives, and yes, we get diets without additives and preservatives, this is true, and this is a particular concern of owners, but if we don't have those things in pet foods, then we have a really short shelf life. That means owners have got to.

Prepare food really frequently, which for many is just too much work. So yes, we can create diets without preservatives and additives, but for the most part they perform a very useful part of the diet. They also can help complete nutrition as well as increasing that shelf life.

All right, what else do we have? Home prepared cooked diets can be used in food elimination trials, absolutely, and this is actually a very good reason to use one, because we can exclude particular foods that we are concerned about, and that could be done in the short term, to test if there's a problem with the food or in the long term if the diet is balanced correctly. We get better control with a home prepared cook diet, and yes, the owner can have 100% ingredient control if that's what they, if that's what they want.

Management of proven adverse reactions to foods or specific diseases. And yes, again, this is where a home prepared cook diet is absolutely a good option because. Sometimes we get multiple concurrent diseases where there is absolutely no suitable therapeutic diet out there and so diets can be specifically formulated for individual need and it we're very lucky to be able to have veterinary nutritionists that can do that for us.

Improved safety? Yes, well, and certainly in terms of improved safety when compared. To a raw meat-based diet, because these ingredients are cooked.

So from a pathogenic point of view, we've got a much less lower risk than we would have done. Improved palatability, very similar to the raw meat-based diet, in some cases, yes, we get better palatability, but there are the same pros and cons, great for picky eaters, not so great for those that are prone to obesity. All right, well, there are lots of good things so far about home prepared cooked diet, but where are the risks?

So again, nutritional imbalances being top of our list when we think about the risks of these diets. Now, these two studies looked at us, looked at 94 recipes, in fact, of different home prepared diets that created for chronic kidney disease in dogs and cats and with dogs with cancer. And when these diets were analysed in these studies, they found every single one of them to be nutritionally inadequate.

Now if we think about those patients, they have chronic progressive diseases. The very last thing that they need is a nutritional deficiency as well. OK, these are very specialist diets that, you know, for specific purposes, it might be quite hard to do with a home prepared cook diet.

Well, all right, what about if we look at maintenance diets for dogs? Surely this is more achievable. So this third study looked at 200 different recipes that were home prepared and made for dogs.

95%. These recipes had a deficiency and in fact over 8, 84% had over one deficiency. And in fact the only diets that didn't have a deficiency were those ones that were designed by a clinical veterinary nutritionist, of some kind.

So it is possible, we know it's possible, but it's highly likely to be deficient. So one of the nutrients that we have particular concern about and one of the ones that comes up very frequently within these diets is low calcium. It seems to be particularly difficult to get into a home prepared cooked diet.

And if we think about our growing cats and dogs and how the formation of normal bone, bone structure should be nice and dense like this. But when we don't have enough calcium, we get osteopenia. So we get this really sort of, much more spongy like bone.

And that is because it's been demineralized. The, body has had to take. Calcium from the bone formation, to correct the levels in the body.

And this is known as nutritional secondary hyperparathyroidism, which of course is to be avoided at all costs. It is, extremely painful for these individuals. It leaves them at high risk of multiple fractures.

I really hope that You're not unlucky enough to come across one of these patients because they really are in a desperate state with a very poor quality of life, often by the time they come in to see us. Mostly, if you're seeing those multiple fractures, and we've got this bone demineralization during growth, it is going to be irreversible. That individual will be affected for the rest of their life.

OK. What about incorrect preparation as far as a home prepared cooked diet goes? Well, this is a bit of a risk because even if we've got a very good diet recipe that's formulated and overseen by one of those suitably qualified individuals, we still need to be making sure that all those ingredients are.

Being thawed properly prior to cooking, we know that then they need to be cooked thoroughly. They need to be then cooled and stored correctly and reheated and cooled before feeding, and of course we need good hygiene throughout. And so there are many places where, preparation may cause an issue.

The other thing that we need to think about is the significant time that these diets take to prepare. And that leads me on to the next problem with home prepared cook diets. It's unaffordable.

So home prepared cook diets are not an easy option. They're not a cheap option in terms of formulation costs, ingredient costs, supplement costs, and in time also there as being a cost to the owner. And really, when an owner sets out on doing one of these diets, we have to check with them, is this going to be a long term option for you?

I've got a very good example here taken from the BSAVA guide to nutrition. Now this example shows how we've got a dog who weighs 12 kg. And what it does is compare the costs of a home prepared cook diet with that of a wet or a dry.

So what we can see here is that the, the, for the first month of a home prepared cook diet, including all the formulation costs, the ingredients costs, shipping costs, supplement costs, we've got a month, first month at 457 pounds 54 pounds and 71 pence. Months after that, because now we've got the supplements at least, and we've had the formulation, we've got a monthly cost of £203.69 it's an incredibly expensive way to feed your pet.

And remember, this is only a 12 kg dog, it's pretty small. Compare that to a middle of the line wet food, and we know wet food's inherently more expensive than dry food. However, we've now got a monthly cost of £37.20 and as you would imagine, dry food's gonna cost much less.

So we've got 8 pounds 40. In the current climate, when we're thinking about every penny with our gas and electric bills and so on going up, do owners really have this amount of money and time to be home preparing food. The problem is if they don't, they're likely to cut corners, they're likely to do things quickly and not be so careful with their diet formulation.

What about the we have risks of, reduced digestibility with cooked foods. Now this is something that is talked about a lot in conjunction with thinking about raw meat-based diets. So we know that when we cook proteins in particular, the digestibility of them is slightly reduced.

But it's only a really minor effect, and actually we can easily account for that in the recipe, whether that's a home prepared recipe or whether that's actually a manufactured recipe. We know that in some other ingredients, however, cooking actually increases digestibility. Thinking of some plant-based ingredients in particular, we get much better digestibility once it's cooked.

And for me, cooking of the food is a small price to pay for the safety that we get from cooking and the lowering of the risks of pathogenic infection. And that kind of leads us all onto the final risk that I have here, and that's poor compliance. It's known as diet drift.

So even when we've got a really good recipe and good formulation, owners are then not being so accurate as time goes on, and it's easily will then unbalance that diet. So some good and some bad as far as home prepared cook diets go. Alright, changing tax and in complete contrast to the raw meat-based diets, we now have a growing interest with our pet owners in vegan diets.

So what are the benefits of feeding a vegan diet? So I'm gonna do the same, look at the claims and look at the evidence. So the first claim is is that we can produce a diet for dogs and cats that uses no animal products, and this is because to be vegan or veganism is much, much more than what is eaten.

It is a way of life. And so pet owners want to include their pets in this way of life. This is why they want to do this.

And yet. Yes, potentially, we can produce some diets for some individuals from, plant-based ingredients only. But is this possible for every species?

I've got a picture of a cat here, you know what's coming. And also, we have to question, is this ethical? I'll come back to this in a moment.

Let's think about dogs first of all, and as far as plant-based and vegan diets go. Well, we know that dogs are more omnivorous than carnivorous in nature. We know that they've genetically varied from wolves, so we've got much greater capacity to digest, plant-based foods.

And certainly they can extract you, and utilise nutrients from those carbohydrates. And we also now know that we've got some plant-based diets, that appear to be well formulated and can be complete and balanced. And so if we, if this is done carefully by somebody with a suitable qualification, we, we may well be able to feed these quite happily to dogs.

And we have Some small studies that show that even at extremes, so such dogs as sled dogs, some huskies can be supported in that extreme of activity on a vegan or a plant-based diet. So dogs, we think this is probably OK, and there are many, many more plant-based or vegan diets coming on the market for dogs because it is nutritionally pretty sound. What about the risks of a vegan diet though?

Well, when we really think about risks, predominantly we think about cats, and we think about nutritional imbalance. So as we all know, cats are obligate carnivores. There is no choice in that.

This is how they are physiologically made. So we have to ask ourselves, is it. Ethical to feed a species that we know to be an obligate carnivore in such contrast to their natural feeding needs.

For me, personally, I think that this is a big ethical question that I will be erring on the side of, no, I don't believe it is ethical. So we all, what we know is cats have essential requirements for some animal-based products. One of the ones that's often talked about is taurine.

It is the most limiting amino acid in most of these diets, but we do now have alternative and synthetic sources. But those may not be bioavailable to the cats. Just because you put those sources in a diet does not mean the cat can extract.

Them. So unless controlled feeding trials are done on those diets, I would be very suspicious and very wary of any plant-based diet that says it's fortified with taurine or added synthetic taurine because it will probably be very difficult for the cat to utilise it. Another nutrient of real importance as far as plant-based diets goes for cats is aracodonic acid.

So there is no synthetic form of arachcodonic acid, there is no plant-based substitute, and cats have to get a acheddonic acid from a, from a meat-based source. Again. Owners have been surveyed about their opinions on what they think about cats and dogs being fed these types of diets, and even though, knowing that there are these risks, apparently the incidence of concern is low, but we should question that evidence right at the start.

I said we should always question and think about, well, who is most likely to partake in a study like this? Is it likely to be people who are proponents of vegan diets being fed to dogs and cats, or is it likely to be somebody who's against it? I'll let you make your own minds up on that one.

So if we are going to even contemplate a vegan diet for cats, it can only be formulated by someone with a suitable qualification, and what they will often do is use egg, if, if the owner has got some friends with garden chickens, then egg might be acceptable, to, to round out that nutritional balance within those diets, but very, very difficult to do. OK. So if you're met with a pet and a pet owner who wants to feed a vegan diet, particularly to cats or with any diet if you've got concerns, it's really about asking the right questions.

WSAVA have this really good guide on the sorts of questions you'd want to be asking a food manufacturer. They include things like, do they use a a veterinary nutritionist to oversee their formulations? And if not, who is overseeing their formulations, who's doing that?

And what are their quality controls that they've got in place. I would be very worried about any food manufacturer that won't give out this information. I would suspect they've got something to hide.

OK. So finally we come on to grain-free diets. What are the benefits of these diets?

Well, firstly, it's important to understand what we mean by grain free diets. So they are going to be diets that don't include all of these things, rice, maize, wheat, wheat, starch, barley, and so on. And a grain free diet, is predominantly, free of grain to, get rid of the types of glutens that were in there and each type of these grains will contain a different type of gluten.

Even when we have a gluten intolerance to one type of gluten, it doesn't mean that we actually have a gluten intolerance to all types of gluten. And actually this blanket approach of getting rid of all types of grain from diets could be causing problems, which we'll talk more about in a moment. What is still included in these diets though is carbohydrates and typically potato is used instead, and this gets quite confusing for owners because they assume that a grain-free diet is a carbohydrate free diet, but of course it absolutely is not.

They will all contain carbohydrates for the most part. So what about these benefits and the evidence? Well, we have a diet that we can have without grains.

Well, yes, we can formulate grain-free diets. But there is really limited evidence that grains and glutens are bad for pets, unless we've got a specifically diagnosed adverse reaction to a grain. So then we can use, grain-free diets in food elimination trials, but only needed if an adverse reaction is suspected.

In fact, adverse reactions to grains are really rare if we take skin disease as an example. Just 1% of skin disease is thought to be due to an adverse reaction to food. And the most common dietary reactions come from beef, dairy, and soya.

Actually, grains, wheat is number 4 on that list, so it's not even highly likely to be the grain source within the food, it's much more likely to be one of these other things. But we can use the grain-free diets to do a food elimination trial if we're suspicious that grain is causing a problem. This is the gold standard method of diagnosis of an adverse reaction to food as we know that serology testing is widely unreliable and we shouldn't be wasting pet owners' money on those tests.

We can only do it with an elimination trial. OK. What about back to these claims?

So it manages skin disease. Well yeah, but only in those specific cases that are actually having a problem with grains. They're suitable for proximal gluten sensitive dyskinesia.

Now this is one of the diseases, it's a horrible neurological disease and most. Found in border terriers, and it causes these abnormal limb movements, these sort of awake seizures, that patients remain conscious through these movements. It's just horrible.

And in fact, a grain free diet for them is integral to the management of these conditions, but this is a very specific condition that we need a gluten-free diet for. OK. So what about things like grains cause allergies?

Well, we have no supporting evidence of that. What about the grains are fillers in the diet? Well, again, we have no supporting evidence and we know that digestibility of grains is potentially very high.

We know nutrients can be extracted from them. What about the grains are harder to digest? Well, no, we don't have any supporting evidence there.

All right, so I'm sure you're aware of some of the risks already of grain-free diets, so I thought I would just touch on this. So we have this claim that grain-free diets are responsible for causing dilated cardiomyopathy in some dogs, and there is some really concerning evidence emerging, and I say emerging because this only really came to the forefront in 2018, and that was in America. What we had was we had dogs with dilated cardiomyopathy linked to the use of grain-free diets.

And when these dogs returned to a grain inclusive diet, many of the clinical signs resolved. Because of this, we still don't know. It may be due to the lack of grains in the diets and the inclusions of things like pea and lentil, which are replacing the grains.

So it might just be those that are the problem rather than the fact that, it's not with grains. We also know that there's some link with taurine concentrations within the diet, and again we've got some sort of conflicting evidence as far as what exactly the link with taurine is. It might be that this is just wider formulation issues.

Many of these diets that were highlighted as causing a problem were boutique brands and it might then, therefore be specific ingredient problems or ingredient interaction problems. The long and short of it is, is that we just do not know. The FDA in America are now not reporting on this anymore.

They are leaving it to the scientists. They're leaving it to research and to academia to provide these this evidence and to do these studies. Here in the UK we have an interesting situation because when we speak to cardiologists, they are very aware, and have probably seen a few cases of this, where we've got DCM in a non-typical breed that does resolve or certainly improve with a great inclusive diet.

But we have no reporting system in the UK. We've got no one to tell about these cases. So it's certainly not limited to America and we certainly could have a problem here, we just have no idea of the extent of that problem.

Because of that, we should question, until we know more, is it safe or to feed a grain-free diet? Should we actually be avoiding these diets for now? I'll leave you with that question.

OK, so just as we finish, I wanted to talk about why would owners choose one of these alternative diets. Well, it may well be because they followed some trusted advice, and that could be from a breeder, from a friend, from pet shops. Hopefully it would be from veterinary professionals and veterinary support staff that they're getting in their information, but we know very well.

But that isn't always the case. We also should question or ask owners to question, who stands to benefit from giving that advice? We hear so often, don't we, that veterinary professionals get kickbacks from pet food.

I mean, goodness, if I did get kickbacks from pet food, I would be far richer than I am now. But there are many people with a vested interest in different types of food. Pet owners may feed these diets because of their beliefs.

It might be a personal belief, an ethical belief, religious or pseudo-scientific. Whatever it is, we are dealing with beliefs here, and that is really important to remember. It could be due to fear, and we know that pet owners want to avoid anything that will cause harm, and we've had these cases with melamine, with vitamin D and vitamin B in the past, and this sort of unnatural, anything that's not naturally occurring that pet owners don't like.

Then we get mistrust, and this always makes me really sad because it's mistrust. In science, mistrust in pet food manufacturers, they put things like sawdust in the, in the diets. Maybe this is because there's poor clarity on some of these ingredients lists.

And if I'm honest, I don't know what all these ingredients either. I mean, tomato pumice, that was a new one on me, and it's essentially a tomato byproduct that we should be using in pet foods. That would be wasted.

Otherwise. So, you know, not all of these things are bad. Of course, we see lots of pet food recalls, although the majority of those are from a raw meat product, and many foods are human foods, of course, are recalled each year also.

And then we get the dislike of certain ingredients such as preservatives and additives, but as we've already mentioned, those fulfil a very specific purpose. We also get owners saying, well, this is really about control. They want to know what they're feeding, they want to be able to avoid anything that causes harm, and we can kind of empathise with that, surely.

They want to be involved in their pet's care, you know, nothing is too much trouble for them. And because they are family members, you know, they sleep on the bed, they lick the owner's face, you know, they have this very, very close relationship with them. So how do we support our pet owners who make these choices to feed these types of diet?

Well, I think the most important thing we can do is listen, really listen to their reasons, because if we do, it probably comes from a good place of not wanting to cause some harm to their pets. And so what we're here to do is to provide education, not let. On this topic.

We're here to have an open discussion on what we know so far, what the available evidence is, so for things like raw meat based diets, we encourage them to cook these diets and really, really strict hygiene, even recognising that that might not be quite enough. Home prepared cook diets, we want somebody to balance these diets to improve safety. With vegan diets, we want somebody to evaluate the suitability for that individual, and for grain free diets, again, we probably should evaluate the need very carefully because of the risks.

If it's not necessary, it may not be the best way forward. It's important we utilise the help that's out there. We do have clinical veterinary nutritionists who are more than happy to help with these with these topics, and of course there are many appropriate supplements, that again, veterinary based supplements, not some of those others that you can find online, and of course helping them maintain accuracy and not allowing them to drift away from whatever their recipe was.

So in summary, we really must be having an evidence-based ethical discussion on the advice that we're giving our pet owners and recognising that there are potential advantages with these diet types, that's got to be balanced against the risk that risks that all these diet types have. We should . Feed these, well, allow pet owners to feed these diets with the correct guidance.

We should often warn against caution with using these diets, but really it's important to listen and understand the pet owner's motivation and help protect those particularly that are at risk. It has been my absolute pleasure to deliver this session to you this evening. Thank you very much for listening.

Georgia, thank you for your time and for your, obviously passionate intelligence on this and bringing it across to us. Thank you so much. And also a huge big thank you to Royal Canon for sponsoring this session.

Just a little bit of housekeeping, folks. We are gonna take some questions now. I promise you, we're not gonna get through all of them.

There have been loads of them. But we will take some for about 5 minutes and then we will be having a 5 minute comfort break. For everybody, including, Georgia, just to get a break and get a little bit of something to, to drink.

And then we will be back. But let's get into some questions. Georgia, I'm going to paraphrase a lot of these because there's a lot of themes coming through.

One of the themes you ended on here was, you know, trust the person or trust the, a professional to give you advice on balancing. Excuse me. Where can people go and find a list of somebody that they can trust?

Yeah, that's, that's really difficult. I mean, mostly the problems come because we, don't have that many clinical veterinary nutritionists in the UK. There's only maybe one or two.

They, they have many more in America though, so the, the, and there are lots of people to contact. I don't know of an actual list. One of good places though to go and get help with this and information is the WSAVA website.

They've got their nutrition tool kit there. And certainly they have some great information for pet owners to kind of help and guide them towards making good decisions. And also BSAVA have the guide to nutrition and they have a separate guide and all of these diet types actually.

That very much lays out in much greater detail than I could go into this evening, the, the pros and cons, the advantages, disadvantages, where the evidence is and where we still don't have enough evidence. And so it, they're, they're there really, all those resources to support these conversations. But yes, I mean, I'm, I'm very happy to, help anyone if they can't find, a board certified nutritionist, in the UK, but there, there are some if you, if you Google them.

Fantastic. Thank you for that. Another theme is, and you raised it about hygiene and, the questions that were all around that of, you know, should you freeze the products for longer to make Sure that pathogens die.

How do you, if you can't just wash a bowl, to get rid of the contaminants or put it through a dishwasher, how should you suggest that people, go about handling and cleaning these bowls and that sort of thing? Yeah, sure, absolutely. I think this is a, this is a big problem.

There's a huge misconception that just washing is fine. I think you would, if you, think about it like treating or sterilising baby bottles, so there are various solutions and that sort of thing that you can use, to thoroughly sterilise, those types of bowls and, feeding areas. But the, the long and short of it is, it's the only way to eradicate the risk.

Is to not bring it in the house in the first place. If it's in the house, you know, and you put it in your fridge, then the door handles touched it, you know, and it's sort of, it, it is very difficult. But, so, yeah, I think there are, you know, I think the solutions like Milton, that sort of thing that you can soak bowls in, to, to eradicate the risk.

As far as freezing, so most pathogens can survive for a Very long time in a frozen state, so extra freezing doesn't actually help. I would be looking for making sure that there is testing at the source. So, again, making sure that before that product is even frozen, the pathogen level and pathothogen risks are very, very low.

Now, of course, different producers of raw foods, will do varying different types of, Of testing. And so you'd probably want to speak to the individual manufacturer about what they do. And if you're unhappy and you don't feel that that is enough or not frequent enough, again, I would probably want to avoid those products.

If they are very set on feeding a raw meat-based diet, it's trying to seek those products with much higher levels of testing and higher levels of sort of pathogen, security, if you want. But even those it doesn't eradicate the risk and we know that there are many manufactured diets that we've found lots of pathogens in that are raw based. Fantastic.

One last question, and I think I'm throwing the floor open here. I'm sorry, we may need to do this. It's a completely separate webinar, but there've been a lot of questions coming through about insect-based, diets for dogs and cats.

Yeah, I am a huge fan. I have to say, because, we have a huge potential to obtain proteins from insect-based sources, and I very much think that this is the future, not only of pet food. I'm really sorry for anyone who's squeamish about it, but probably human food too.

Mainly because the pressure currently on, The proteins that we put into pet foods is becoming so high, we're gonna see food shortages in the next 50 years if we don't change something, if we don't source proteins from somewhere else. So, again, those diets have got to be complete and balanced. They've got to go through feeding trials and, you know, give some assurance that they are created in a complete and balanced manner.

But no, I personally am all for the insects. Bring them on. Fantastic.

Folks, that's all we have time for now. I did promise you we wouldn't get to all of them. We are going to take a comfort break for about 3 or 4 minutes, and we will aim to start again at approximately 8 o'clock.

So go and empty, refill, whatever you've got to do, and we will see you in a couple of minutes. Thank you. Right, folks, we are back.

Georgia, welcome back and thank you so much for the first part of this presentation. As per your request, I have opened up the chat box. Would you mind sharing your screen and explain to everybody what it is that you want them to do and how you want them to interact in this next section, please?

Yes, absolutely. Thank you very much. I'm very excited to be, delivering this session.

We are really gonna get interactive. So yeah, first job for everybody, locate the chat box. I want you to be able to see the chat stream coming through.

I've got the chat box open also, so I can see all your amazing comments. So this session is not going to work properly without you, so I really, really need you to interact. I'm, I'm good to go when you are, Bruce.

OK. So, the first thing that we're going to do in this session is I'm gonna test your knowledge on obesity, don't worry, it's nothing too taxing. I'm gonna go through 5 multi-choice questions with you.

The middle bit to this session, we're going, I want you to share your thoughts. I want you to tell me and to tell everyone else who's logged on this evening, what you think to the questions that I'm going to pose to you. And I'm going to finish up with going through a case quite in detail with you.

And I want your thoughts again on how we manage these cases. So this is really an opportunity for you to share your experience, not just me, but with everybody that we've got logged on this evening. What I really need you to do is, yes, participate with me, interact with what I'm going to ask of you.

Try and Think outside the box if you can. I love something that I've never heard before and I'm sure there is so much out there with everyone logged on this evening. Essentially you've got to talk to me.

So please, please put your thoughts and comments in the chat box. So hopefully, everyone's located that chat box. And so your first task this evening, who am I speaking to?

Who's out there? Say a little hello to me just to make sure this is all working properly. Drop me an emoji if you want, and we should hopefully see some coming in.

Hi, Ashley, you were fastest finger first there. Wonderful. Hey from Texas, fantastic.

Lots and lots of you, brilliant. Hello from islands, hello from South Africa. This is incredible.

Wonderful. From Brighton in the UK and the Scottish Highlands. From the Ukraine.

Hi. Excellent, good. You've all absolutely got what we need to do this in this session.

Perfect. So, because this is a little bit of a different type of session, hello from Poland and Jersey. Because this is a different type of session, I wanted to just highlight these two webinars to you.

So, much of the background and theory will be contained in these two, much more detail than I can go into tonight. So please go ahead, and check these out on the webinar vet platform. They are freely accessible to everybody, so hopefully all the information you need will be in there.

OK, so I promised you, we're gonna test your knowledge first of all. So question one, what percentage of juvenile dogs in the UK are thought to have overweight or obesity? So you can use the letters or the percentage, it's totally up to you.

So we've got 37%, 21%, 49%, and 14%. Now looking at the answers coming in, lots of A's, well, to be honest, I think you can see it's a very mixed bag of all sorts, lots of A's actually I think coming in wonderful. So let's find out.

It is in fact 37%. Now that really is a pretty worrying figure, and we think that around 65% of dogs in the UK have overweight or obesity. 37% of those are juveniles, so if we already think we've got a real issue here in the UK at least, and then, you know, the future is not going to be looking great, is it, with so many over.

A third of our growing puppies, already having obesity. So, so yes. OK.

One very good way to prevent obesity is to monitor growth. And although I don't have time to talk about growth charts today, if you go to this website, Waltham.com, it will give you a lot more information about puppy growth charts and how we can hopefully prevent obesity happening before it even starts.

Alright, on to question two. What percentage of cats in the UK are thought to have overweight or obesity? Oh, A's coming in, flying fast in through the door, 55%, 23%, 39%, or 41%.

I would guess looking at all of these, it's got to be a, a few D's coming in there too, let's see. Yeah, not too many bees. OK, yeah, we all suspect, I think that these numbers are pretty high.

OK, so let's reveal our answer. It's 39%. However, this study that we have in the UK is actually one from 13 years ago, and this is going to be likely a far higher number.

The evidence that we have for this is that in America, the Association of Pet Obesity Prevention, they surveyed in 2018 and found that 60% of cats in America have overweight or obesity, and so we're very likely to experience that sort of number here in the UK and of course other parts of the world as well. So big problems for both our cats and our dogs. OK.

So typically, by what percentage do you have to restrict calories by to get weight loss? Do you need a 20% restriction, 40%, 60%, or 10%? Got lots of A's and B's coming in, I think.

Yeah, wonderful. Thank you so much everyone for participating. This is awesome to see these streams coming in of answers.

So yeah, Miss A some B is lovely, OK. So, it is around 40%, so in fact, 30 to 50%, probably depending on the individual, is how much we have to reduce calories by to actually see weight loss. And this is really important for us because if we don't restrict calories enough, we simply won't get weight loss.

It is all about the calorie balance. I say all, at the bottom of weight management, it's the calorie balance. There's an awful lot more to it than that.

OK, so question 4, what is the ideal rate of weight loss in cats? This is per week. So would we want ideally 0.5 to 2%, 2 to 3%, 1 to 2%, or over 4%?

What would be looking for? Lots of A's, B's and Cs, OK, not, no D's, I don't think, yeah, mostly Cs. Excellent.

Yeah, we're all in the right ballpark, aren't we? So the answer is in fact 0.5 to 2%.

For dogs, the ideal rate would be 0.5 to 3%. These represent what safe weight loss looks like.

Now many of you might have gone for France to see that 1 to 2% per week is the ideal. And yes, you will see in much literature that is what is suggested as ideal weight loss, but we have to remember that the studies that that those figures came from were in fact colony studies. They were colony animals were with a very controlled environment.

What we're dealing with here are pets. So for pets and specifically thinking about our cases at the weight management clinic in Liverpool, they lose on average around 0.8% per week.

So for a cat, if they're hitting anything between 0.5 and 2%, I am very happy with that. So that's why it's answer A, rather than B or C.

OK, moving on. So this is little Cujo here. You are presented with a dog like Cujo, with a body condition that is in excess of the BCS of 9 out of 9.

Where are you going to look for further information to help determine his ideal weight? Is it going to be from the weight of the siblings? Take the owner's opinion, ask what the Kennel Club's standard is, or have a look in the patient history.

Lots of answers D coming in, wonderful. All of them. Yeah, I agree, all of this information would actually be really useful to us, wouldn't it?

But yes, you've absolutely nailed it. We would be wanting to look in that patient history to really find that information that we need. So where we'd want to look.

Is just prior to early neutering, depending on the breed, of course, early neutering is gonna be at a different age. And we're looking for ideal body condition score at that point. Oh, yeah, poor pooch.

I, I totally agree. Life is no fun being Cujo, unfortunately. So when we get that weight just prior to early neutering, it's likely to be similar to the ideal weight as an adult.

And one thing that we can do again with a puppy growth chart is to plot their growth. And once we've started plotting their growth, we will then get if we follow the centre. An early indication of that ideal weight.

So even if they have become overweight, in their adolescence, as we know, 37% in the UK are at least, we have also another early indicator that will give us some better idea of what weight this poor little thing should be. The reason that the reason that this is so important is because when we are thinking about obesity care and we're thinking about devising, devising a weight loss plan for them, we have to base the calorie amount on their ideal weight. If we.

Base it on an interim weight or something else in between, you won't get enough calorie restriction and you won't see weight loss. So even if you don't intend to take them back to their ideal weight, we still have to do those calculations on it. So it's always worth going the extra mile to finding out what those numbers are.

OK, so in this part, I want you to share your thoughts on what I'm going to present. Now you'll have to bear with me, there is an incredible 891 of you on this evening. I'm going to capture as many thoughts as I possibly can.

So the first thing that I want you to answer for me is why should we worry about obesity in pets? What are your concerns? Health, straight in there, yes, joints, quality of life, diabetes, animal welfare, their hearts, yes, their longevity.

Lots and lots of joint disease. I think I know which ones you're looking at just on this picture here. Yeah, quality of life coming through really frequently, really nice to see that.

Pro-inflammatory state, I couldn't agree more. We absolutely are going to be under the influence of widespread inflammation, diabetes. Yes, particularly for cats that we'd be wondering about.

The cost of obesity. What a good comment. Absolutely, obesity is going to, give us a cost, whether it's to health or financial.

Yeah, lovely, great, great reasons all, all flowing through there. Perfect. I hope you can all see them as well.

So yeah, orthopaedic disease, I think it was top of your list. It's certainly top of my list too, followed very swiftly by airway disease. If we think about all those brachycephalic breeds, they really are in trouble, aren't they, with that narrow airway, and then you add obesity on, as you can see with this staffy here just how much additional, body fat she has around her neck there.

Metabolic disorders, yeah, absolutely. diabetes is on the list of concerns for cats in particular. Occasionally we do see it in dogs also.

Urinary disease, so this is our FLUTD syndrome in cats in particular, larger male cats that are overweight, particularly susceptible to that, sitting around, not getting out as much as they should do. We have increased risks. So we have increased anaesthetic risk.

We have increased, surgical risk simply because these things are much more difficult to manage, under anaesthesia. And maybe owners would say, Well, hang on, I'm not planning any surgery. Yeah, but what if that dog was Hit by a car, or what if that cat was hit by a car, the outcome of that injury can be directly, reflected in the fact that they had obesity at the time of that accident.

So, yes, healing issues, we've had a comment there. I, I agree, we've then got also, issues following on from that. And we also see really poor skin and coat for these individuals.

Mainly this is an inability to groom and self-care, and again, for a cat's point of view, if you think about the inability to keep yourself clean, cats are such fastidious cleaners, this really is detrimental to quality of life. But yes, as many of you have also said, the biggest reasons we worry here is the reduced quality of life. It is no fun being any of these guys, I can assure you, and the reduced lifespan.

And you don't have to have obesity as a cat or a dog to the degree shown in these pictures. Even moderate amounts of obesity, sort of a body condition score of 7 has been shown to reduce lifespan by around 2 years. So it really is vital that we try all we can to maintain a healthy weight for these individuals.

OK, so I'm really interested. We've got so many people from around the world. I am literally so excited.

So what tools do you have in practise to help start this conversation with your pet owners about their pet's weight? So we've got scales, body condition score charts, excellent. Yep, posters, get them up on the wall.

Yeah, our fabulous nurses. Oh, a little shout out for that one. I like seeing that come through nurse clinics, nutrition clinics, tape measures.

Wonderful. You've all got lots of good things. Some 6 monthly health checks.

Yeah, definitely. Let's have these conversations, some growth. Charts, perfect.

Lots of really good items that you've got in practises. I'm so good. It's so nice to see you're so well equipped.

And I've at least got something, that you can have, in practise that's gonna help you start having these, having these conversations with the pet owner. So here's one of my posters that I have up in my consulting room. We occasionally let our patients take their own body condition score, at least Humphrey here is having a good look.

So yes, lots of the things that you've already said that I had on my list. So waiting room displays, body condition score charts up on the wall. We've got resources from WSAVA, come up in the chat there, yes, absolutely they've got some excellent resources there also.

Some visible scales, just having your scales out in the waiting room will encourage pet owners to go and weigh their pet. Great, let's, let's pop them on every time they come in. I also have a wall of fame.

I am lucky enough to have had so many successes over the last, 7 years, nearly 8 actually, at being at Liverpool. And I really love celebrating my success stories because if nothing else, it's really inspirational for those other pet owners. It absolutely can be done, and these guys here are living proof of some of that.

We also have posters up around the place, and hopefully some of you may have some little referral cards, so that your patients, if you're identifying obesity can easily be referred to the person within your practise who is going to then go on and manage that obesity for that patient and that owner. So something. Nice and quick.

This is probably something you want to hook up with your veterinary support staff, so everyone knows when an owner comes out of the consulting room with their little card. They know that we really need to, start booking them in for some additional help. There is also these, I don't, sorry, the picture's a little bit small, but this is, a little board.

It kind of helps owners start to feel the differences between the body condition scores. They are pretty good, but if nothing else, they really entice owners to have a look and start touching then of course, what a great opportunity to start having a chat about so many of these things. OK.

So, what are your ideal elements from a weight loss diet? If you are choosing a weight loss diet out of the millions of different diets out there, what are the things that come on your list? High satiety, Emily, straight in there.

Yes, absolutely, I agree. Low calorie, palatable, filling, balanced. These are wonderful.

Things, yes. Easy client compliance, we want some wet diets, yes, absolutely we do. We want some, some options, don't we?

Fibre, yes, we want fibre in the diet. What else have we got coming through? Good proteins?

Yes, we'd want to see that. We want something that's cost effective. Yes, absolutely, I agree with all.

All of these comments. A lower fat diet. Well, yes, the, high numbers of calories come through the fat.

So certainly we'd want a low fat diet. Low calorie treats, yes. I'm not quite sure who that person was, but yes, definitely, we'd want you to think about treats as well as the actual food itself.

Watermelon as treats. Awesome. Yes, I totally agree.

Well, let's have a look what I had on my list. So the first thing that I had on my list, complete nutrition. Well done for getting in there.

So yes, complete and balanced for weight loss, and this is absolutely vital. A diet that's complete and balanced for maintenance is not suitable for weight loss, so we want something that is going to be safe for weight loss. So balanced correctly for that calorie reduction, but nice and nutrient dense to make sure they're getting everything.

We've had lots of people saying it, we want these diets to be satisfying, we want them to be filling, and this because we want to prevent food seeking behaviours. There's nothing that's gonna derail an obesity case quicker than when we've got a lot of food seeking behaviours. So yes, absolutely.

We want to be able to give a large volume. Pet owners are always going to want to put lots of food in the bowl, and we also want lots of food to give throughout the day, to give the owner the flexibility of giving food, when food is needed. So that's really important.

Palatable, whatever the diet food is, it must be palatable. It's got to be accepted. It doesn't matter how good your weight loss food is, if nothing will eat it, it fails as a food.

So of course the food has got to be palatable. High in protein and high in fibre, we have both of those things mentioned here. So these are the nutrients that are most satisfying, particularly in dogs, high protein and high fibre is what we need.

We that fibre gives us a good volume, it also slows gastric emptying, that kind of fuller for longer feeling, which you would really want. The last thing we've got here is increased chewing. Now, there are ways of Increasing chewing specifically with kibble shape and size.

And the reason we'd want them to chew is because that will slow the intake, and the slower they eat, the better the feelings of fullness are, because the stomach, with its stretch receptors actually takes time to tell the brain that it's full. So if we can slow down that eating, getting them to chew much more, then we can actually improve the feelings of fullness with the same food, even though they're just eating it in a different way. Wonderful and thank you for your thoughts.

OK, and pose a little case to you, so your dog, it's this beautiful Dalmatian here, needs to lose weight, but it's struggling, OK. So what would you suggest to this owner, who has 2 dogs and they have 3 cats, as you can see here, busy family. The dog likes to eat the cat food pretty regularly.

It also scavenges any food, and the owners like to feed the birds. What would we be suggesting, in these instances? Separate rooms, I saw coming in there.

Chip operated feeders. Yes, feed the cats up higher, microchip feeders, yes, I would be all over those, getting the cat food up off the floor. Weigh the food out, yes, that's a great one.

Bird feeders. Yeah, let's just put the bird food out of the way. Hey.

That would make much more sense. What else? We've got puzzle feeders, using bird tables.

Yeah, we've got lots of great ideas coming in here, feeding those cats. We know cats like to be, up on a high shelf, don't we? So, why not snuffle mats?

Yes, I love a snuffle mat, for my patience. Get more exercise in? Yeah, absolutely.

We should recognise, though, that predominantly weight loss is done through the foods. So 95% of weight loss is accredited to food, and 5% only is accredited to exercise. So being a little bit careful with over-egging the exercise portion, but certainly it is needed.

So yes, we've got all, lots and lots of good things coming in here. Perfect. What did I have on my list?

Well, pretty much everything that you've just said. Wonderful. So separate the cats and dogs at mealtimes.

It sounds so simple, doesn't it? And yet sometimes pet owners need leading towards that. Prevent them raiding the bin.

I mean, dogs just love to do this, and especially if they do it once and are successful, then it's a really good reason to do it again, isn't it? Feed the dogs separately so we've got no bowl swapping. And actually, if we've got small dogs, we can use microchip feeders for the small dogs, not just for the cats, so that we really do eliminate any bowl swapping.

Put the cat food out of the dog's reach. Yeah, lots of people coming in with that answer. Microchip feeders are really, really useful.

These used to be incredibly, expensive. The price is coming down now, which is really good to see, and they're becoming much, much more affordable. Feed the wildlife elsewhere, and maybe just switch to seed rather than the fat balls or feed them round the front of the house where the dogs don't go, that sort of thing, that would be my advice.

And then don't ever leave food out. We don't want these dogs counter surfing, you know, jumping on the table. We know how agile Dalmatians can be.

They can be very naughty when they want to be. So just not leaving any opportunity at all. Now, you might be wondering why on earth I've got a picture of a washing basket on this picture.

On this slide, sorry. Well, this is a story that came from my, I spent a week or so in Canada, and it was a lady who had 8 cats and she had 8 washing baskets. And her method of stopping her cat sharing food was to place a washing basket over the top of every cat when it was at its food bowl.

Now, I'm not too sure what the behaviourists would think of this, especially as cats are meant to be solitary. However, it was a solution that worked for her. She said the cats preferred eating together.

Again, that was her opinion. However, this is quite a nice out of the box thinking solution to that situation with 8 cats, and certainly multi-cat households can be very difficult. So sometimes it's just a note to say we do have to go to the small extremes or the slightly odds to find a solution.

OK, so we've got this patient, we know, we know they're struggling. So the owner is using a dry therapeutic diet designed for weight loss, and they portion it out with a scoop. So they're not doing too badly.

The dog gets 20 minutes of walks each day, but is always begging for food. What would you be suggesting to these owners? What kind of things, weigh it, yes, straight in there with weight, blood work, yeah, we, we probably would want to check, make sure general health is good, split up the meals, yes, definitely.

Yeah, 20 minutes of walk. It's probably not enough for a Dalmatian, is it? Absolutely.

Keep the dog active and busy, Robin, I totally agree. More exercise, more entertainment, getting those, that brain working and not so focused on food. I completely agree.

Lots of very nice ideas coming through. Through puzzle feeders, much more enrichment. Yeah, some healthy treat options, switch to a wet food.

Yeah, wet food is inherently bulkier, because of the water content in there. Put food in things like toys, yes, definitely splitting up the meals again. Wonderful, more exercise.

Yeah, great. Lovely. What did I have on my list this time?

So things that I thought was, yes, we need to, weigh out food on digital scales. It's so important that we're accurate with these plans, not just because accuracy is going to get us better results ultimately, but also Because if you want to make a small adjustment, you simply cannot do that with a cup or a scoop. Frequently with cats, I'll reduce food by just 5 grammes, you just can't do that with a scoop.

So weighing the food out on digital scales if owners do very little else certainly will help increase their chances of success. Divide up the food, I think we had some of these in there, definitely, so we could have 3 meals a day, 4 meals a day, 6 meals a day if that suits the owner. And we also don't have to have, we don't have to have different, sorry, the same amounts each meal, so you can have.

A smaller breakfast and a smaller lunch, saving the majority of the food for the evening when food seeking behaviours are much higher. The dog in a sense is getting no more food throughout the day, however, there is food there when the dog and owner are needing and looking for it, and that's really important to get success. So keeping a large reward portion as well, excuse me, certainly.

Sorry, I've, I've been talking rather a long time. I'm dry now. So certainly keeping a big reward portion to one side, making sure, again, we've got flexible food for when the owners use it, slow feeder bowls.

We've got lots of those, that were suggested in your comments there. There are so many wonderful toys and things now that you can give. There's proper puzzles, there's Kong wobblers, and these puzzle toys, both for cat.

And dogs as lick mats for wet food, there's just no excuse now not to get them, using lots of different toys. We can add in some green watery vegetables. Now I saw a lot of people suggesting carrots, and carrots aren't wrong or bad.

However, they're not really my favourite only because, carrots are a root vegetable. And contain a certain amount of carbohydrate, whereas vegetables like this, broccoli, cauliflower, and courgette, they are much, much higher in water. And if we compare carrot and courgette, the courgette is 4 times less calories than the carrots.

So piece of carrot, perfectly fine. If you want to give volume, though, I would be going for the green watery ones. So all of things sprouts, green beans, watermelon, I think we had coming through there.

Green beans, Marilyn, yes, you got there before me. Cucumber, Natalie, perfect. Yeah, anything.

Like that would be absolutely fine. It's a really good treat alternative. I always say they can have cucumber till it literally comes out of their ears.

Oh, we've got a little comment if they're, cooked or uncooked. Yes. So I would be saying, whatever the pet prefers, you can cook these things if the owners can be bothered.

Certainly things like, courgette or cucumber would obviously be given raw zucchini, Daniella, sorry, yes, I forget, that it also has an alternative name. Cats like courgette, they certainly do. OK.

Other things that I would want to be considering are things like we've got, you know, we want some consistent rewards because if that dog or cat isn't expecting a reward, we should have something to give. Now getting nothing is rubbish, and yes, dogs can detect the differences between bacon and biscuits, however, it is just important that we give something and so. Either having a green veg alternative or having a good reward portion can certainly help, with those foods seeking behaviours.

Altering the wet and dry, we also had that come through in the comments. Yeah, brilliant because wet is definitely more bulky. And finally, once we increase that activity level, we've said this already, we want to entertain their brain, get it focused on other things.

OK, let's leave our dog behind, and now we're coming on to Handsome Thor. OK. So you're seeing 3 year old Thaor for obesity care.

Thor's plan's been going pretty well, and he's been losing at an average of 0.6% per week, but the weight loss has now stalled and he's remained the same weight for the last two months, so. The family have got another cat, they've got a dog and they've got two small children.

Thor can come and go as he likes and is often found counter to serving surfing, especially in the bacon pan. What would you be suggesting that is going wrong? The stress factor, yeah, well, if he doesn't get on with the other cat, Kim, I agree, we certainly should be considering that.

The kids feeding the cat, yeah, I'm afraid it probably is gonna happen, isn't it? Neighbours feeding. Oh, well, those damn neighbours, definitely could be a problem.

What else have we got? Yeah, the free range access outside means who knows what he's eating outside, and what he's actually picking up. He could well be hunting, Jane, yes, you're absolutely right.

Cats will supplement their own diet with things that they can catch. Might be stealing food. Yeah, I would probably think so.

1st, 2nd and 3rd breakfasts. Yeah, I don't. Do it, especially if there's not good communication within this house.

We've got, you might be stealing other pets food, lots and lots of similar comments, I think, getting food elsewhere. And I think owners often think they probably have 2 or 32 or 3 houses. Grandpa, in specifically secretly feeding.

That sounds like there's a story there, doesn't it? So yes, lots and lots of very good thoughts on this one. The things that I had here was maybe the owner has changed the food, and this happens more often than I ever imagined it's going to, but it does happen and sometimes you just have to ask, is it on the right food still?

It could be getting extras, whether that's treats, wet foods, scraps, absolutely, eating the other pet's food, a mate weights being, estimated, not weighed anymore. Maybe the owners got lazy with these things now, could be eating elsewhere at 2nd and 3rd homes. Hunting more, yes, you've got all these nice getting food from children, raiding the bin, licking saucepans, house sitter, babysitter and granddad, apparently.

Eating food that left out for the wildlife, certainly fat balls definitely unfortunately are very, very highly palatable to dogs and cats, and they will frequently try and get a little treat there. They might have started some training. Now we know we can train dogs and cats, and of course we'll need a high food reward, for that type of thing.

They may have changed their activity level, we may have had something else going on, some illness, some new medication. There are medications such as steroids and anti-epilepsy drugs that increase appetite, so food seeking behaviours increase, therefore food intake increases, so yes, lots and lots. Of good ideas there, well done.

OK. One way that I try and get at some of this information, if things are going wrong, is to ask owners to fill out a food diary for me. And not just the owner, try and get, try and get the family involved.

Yeah, I, in what's going on here so that we can kind of get everyone's input on what's happening, and just keeping a diary for a few weeks and really being like a detective and trying to find where those problems are coming from to hopefully then make some good suggestions at fixing them. Wonderful. So in this last 3rd, we're going to be talking through one specific case, OK.

So wanted to firstly introduce Chester to you. Now, Chester, I have known for a good many years now, and his owners have been wonderful enough, to share a lot of his journey with me, which is why you'll see lots of lovely pictures and videos in these next few slides. So to tell you the full background on Chester, don't worry, you'll be able to see these bits of information throughout.

So he's a domestic short-haired, he's male and he's neutered. He's 7 years old and currently weighs 9.1 kg and was given a body condition score of 9 out of 9.

From his owner's point of view, he has 2 female owners, one of them that works from home, and he lives in a ground floor ground floor flat. Owners are both of average weight and one owner's had cats all their life, so not totally inexperienced. Background and exercise.

Well, Chester is described as a really bold cat. However, he is mostly very sedentary, he sleeps for over 12 hours a day and can get quite aggressive when he's frustrated, particularly with the owners, but also, as you can see here, yes, he lives with Timmy. He, so Timmy is their new little kitten, which is kind of upset the apple cart a little bit.

It's rocked the boat somewhat. Chester is allowed outside during the day. We know that these two cats don't get on very well.

Chester has a preference for dry food, and we know that when the owners go away, we get the neighbours to Feed the cats. So, from a medical history point of view, we have in inverted commas, urinary problems, but these weren't ever investigated and actually they're resolved with some non-steroidals and some nutraceuticals. He is up to date with his vaccine history, and he's regularly freed and wormed and he is insured.

So we've got lots of thoughts coming in already, yeah, I, I love that dash camera on Chester, yeah, perfect, maybe dash camera on the Neighbours too. So I'm going to, ask you throughout this section, we're firstly gonna think about the medical conditions. What are we worried about for Chester?

We're then gonna think about, OK, what are the suitable foods to feed based on what our, priorities are. We're gonna think about why we have chosen those foods and what other options we might have. We'll think about Chester's ideal weight, how best to divide up this food, how to introduce the food to Chester.

How we manage his behaviour, how can we increase his activity, what other elements we have in his plan, and what can we do when the owner's gone away, so I can see people having lots of thoughts already, so wonderful. So we'll take it step by step, one question at a time. So what is on your list of main medical considerations?

If you're presented with Chester, what are you thinking? We've got diabetes and hepatic lipidosis coming straight in. I'm not surprised.

Diabetes, osteoarthritis. Yeah, we absolutely could. I mean, he's 7, he's not that old yet.

We've got stress cystitis in the past, most likely, yeah, orthopaedic disease. Could be hypothyroidism. Well, hypothyroid in cats is extremely rare to unheard of.

It's highly unlikely that to be the case. If we were dealing with a dog though, I absolutely agree we should be thinking thyroid and potentially if weight loss doesn't go well, testing for it, but not jumping in too soon, hypothyroidism in dogs is pretty rare. So yeah, we've got lots of things, urinary issues, pancreatitis potentially, yeah, we've got lots and lots of things on these lists here, very, very good thinking, everyone.

Interestingly, the very first thing on my list. Was obesity. It's probably too obvious, isn't it?

We're in an in an obesity, session. But obesity is probably going to be top of my list of the reasons that I would be worried for Chester. We also know that through obesity, we've got additional risk factors for urinary disease, and so we'd strongly be recommending, weight loss in Chester's case.

The second thing that would be on our list is the urinary disease. Was there a stress consideration? Lots and lots of you have already picked up on that one.

Excellent. And of course, for any urinary disease, we're going to be wanting dilution at the very minimum. Diabetes is absolutely going to be on that list, and also I have renal disease on my list, mainly because of the age that he is, as he becomes senior, we would be worried much, much more about the.

The chances of renal disease as a primary killer in cats, we'd certainly be wanting to on the list. For the purposes of, this session, we're very much going to focus on obesity and urinary disease because we don't have access to blood, so you may well want to do blood work to see if he is at risk of some of those other things. But we'll move forward with obesity and urinary disease as concurrent diseases that we need to manage together.

So, first question to you, now is how can we increase the water intake? Whatever we do, we're going to need to get more water on board. Wet foods, water fountains, add water, catnip tea.

Oh wow, I haven't heard that one before, that's an awesome answer. I want my cat loves catnip. I wonder if she'd like it.

Yeah, lots and lots of different, adding water to the food. Yeah. Wonderful answers coming through.

So, yes. Things like this, dripping taps. Well, rainwater.

Yeah, it's a good point actually. Cats don't always like what they're presented with, especially if it has a strong smell of some sort. I turn a.

We could flavour water to increase, water intake. Definitely. Doing things like cooking a chicken breast and then giving the cat the chicken water can definitely increase, drinking, different broths, bouillon, that sort of thing.

As long as it's low salt, those sorts of things are great. And yes, Joanne, we do have, some specific products now, to increase hydration. Excellent.

The other one that we had, I don't think anyone's mentioned it, but we are back to green watery vegetables because cats, as somebody said, will eat courgette or zucchini, as well as dogs. And of course, not only is this a very good, low calorie food, it is also very high in water. So if he likes it.

Great. Your cat loves broccoli, Rachel. That's awesome.

Yeah, there shouldn't be any problems with broccoli. Do have to be a little bit careful of the calcium levels in some of the green vegetables, the leafy ones in particular. But yes.

So Chester ate, courgette Zucchini throughout his whole weight loss, and he did extremely well, as you'll see at the end. There he is. OK.

So now we've got a bit of a dilemma, haven't we? What sort of food are we going to feed him? What therapeutic diet is going to be most suitable?

And what, what is influencing your choice here? Ashley, straight in with satiety. We've got some wet food, yes.

What else have we got? Some, yeah, some, some multi-function foods, brilliant. Great.

So we've also got urinary mod calories, so that's a lower calorie urinary. Foods, some diabetic food, potentially. Well, if you, if we were, you know, treating for diabetic, then yes, absolutely.

Yeah, we've got multi-function foods coming in again, some weight loss control, weight loss foods, got lots and lots of those. Yes, lots of things on the list. So now I'm interested in what are, what's the sort of the swaying factors for you.

What is it that you're looking for in these diets? That's going to be particularly important. Cat's preference, yeah, absolutely.

Something, Elizabeth in, something to regulate the, the pH of the urine, that would absolutely be a consideration. Balance for weight loss, Nicola, yeah, totally agree. Affordable and palatable, Liz, yes, definitely we'd want something that the cat's gonna actually eat for us, wouldn't we?

So yeah, lovely. OK. So, the, foods that I had on my list.

So in the suitable foods, we'd be looking at the weight management diets, or the multi-function diets, something that controls the weight loss diet with a urinary diet. It is really important to note at this point that urinary diets are not suitable for weight loss on their own. OK?

Even the Low calorie urinary diets, they're not balanced for weight loss. They are balanced for maintenance. And so when we're dealing with a case like Chester, whose obesity is gonna be so affecting his quality of life, we need to be really, really careful that we're choosing the correct diet.

So it'd be a weight management diet or a multily function diet, not just a urinary diet, OK? The factors that influence our choice, we want wet and dry options. Yes, we've had lots of people say that, absolutely, we want to be able to give him choice, don't we?

Availability. So how easy is it for the owner to access this food? What products do you stock in your practise?

That alone could be the deciding factor. Couldn't it? We've got some, yeah, Chester's, flavour and texture preferences.

Yeah, we've got to match the food, to what Chester is going to prefer. We also want all those nutrients that we've talked about already that promote feelings of fullness because we don't want this, to be any more difficult for Chester than it need be. OK, so hopefully we're gonna not all faint at the thought of a little bit of maths this evening.

So what would you calculate Chester's ideal weight to be? Let's see what we get. Karen's straight in there with 5 kg.

OK, 5.8, 4.5, 5 to 6 kg.

They've got 4, 4.2. Lots of 5 kg coming in 8.5 from somebody.

I can't catch the names, everyone's coming in so quickly. 5 to 6 kg, yeah, we're getting a ballpark feeling here, aren't we? Some is some down at sort of 4 kg.

Yeah, let's have a look. 3.7, Anna.

Oh, that's low, isn't it? Yeah, 6.54 to 5 kg.

Wonderful. He is a big cat for sure. And of course, if you saw him in your practise, there might be an easier way of determining, determining his ideal weight.

Well, we have specific calculations that we can try. I see some of you have already got there. And this is about using the body condition, and the appropriate calculations.

So if we said that Chester's ideal weight, is based. On him having a body condition score of 49 out of 9, that puts him at 40% overweight, so we take the current weight, we divide it by 1.4, and we get 6.5.

Now what's your general opinion? Do we think 6.5 is the right number for Chester?

Do you think it's too high? No, no, lots of people would need, yeah, not, yeah, a little bit lower maybe. If he's a big cat, then maybe that's OK, a bit too high, yeah, you're absolutely there.

So for me, that, you know, there are not many domestic short hairs at 6.5 kg as a Maine Coon owner, and she isn't even. 65 kgs.

A domestic short hair is very, very unlikely, to be that weight. So, as lots of you have already said, and brilliant, we need to check back in his history. We need to look for that weight just prior to early neutering that we spoke about earlier.

Oh, you've got a Maine Coon at 6 kg. Yeah, wonderful. So, looking for that, weight just prior to early neutering.

Is a really good way of getting a much more reliable ideal weight to base our plan on. Yeah, tiny little feats, I agree. They are teeny tiny, aren't they?

OK, so given the information that we have on sort of Chester's attitudes and daily lifestyle, how would you divide up his food? What would you do? Is he gonna have it all in one go?

Or what else would you do potentially? Many small portions straight in there and puzzle feeding also, yes, I absolutely agree. Timer feeder, perfect, he doesn't have to bother the owners for food then.

Two main meals and a small lunch, love it. Yeah, bowl free feeding, yes, definitely. Great.

Lots of puzzles, 4 or more meals, several meals. Yeah, lovely. So all these things are really, really good ideas.

Encourage hunting for food. Well, we certainly could do if, as long as Timmy doesn't get involved and swipe it while he's not looking. Activity boards, yes, definitely.

All these things are great, great ideas. Me, I personally like small multiple meals for cats. Cats will eat naturally up to 16 times a day.

So we do need to recognise that they may just want to eat little and often, and I'd always say 5 grammes as a sort of, little reward portion to give flexibly at another time. OK. How would you suggest that Chester's owners transition him to this food?

What is your standard or what would you think you would need to advise for Chester? Are we just going to, tomorrow, let's change it straight on. Gradually, we've got from lots of people, slow and steady.

Yeah, lovely. Lots of people go, gradually 7 days, 14 days, 10 days, 1 week. Yeah, wonderful.

. Yes, definitely, I agree with all of these. I think the general idea is slowly, isn't it? So it really depends on the individual, how slowly we do this, but certainly we want to go slow enough to prevent digestive disturbance and to also gain really good acceptance from the food.

The standard advice is kind of 4 to 7 days, something that looks like this. However, I like to tailor it much more specifically to the individual. So if there's a cat that will eat anything 3 to 4 days, happy to eat most things, right, 4 to 7 should be fine.

Any cat that's picky, up to 7 up to 10 days, any fussy eaters up to 14 days, and the very resistant we can take up to 2 weeks. Even if you have to change one kibble at a time, weight loss is so important for Chester's health that it is worth taking that time over, so gradual really does mean gradual. OK, how can we manage his behaviour and frustration and increase his general activity?

I feel like we've had lots of suggestions already, but what do you think? Puzzle feeders, Lucy, yeah, straight in. I would definitely be thinking about them.

A bit of play, yes, and fell away to try and reduce some of that anxiety or annoyance that he's feeling, pain relief. And I've seen that coming through lots and while we've been talking about Chester, it is a very reasonable consideration to make sure he is not painful at all. Foraging for food, absolutely more playtime, yes.

Perfect, some great answers. All of these things that you've just said. We can add in there some maybe some don't feed me cos, separating them at mealtime so that we're, you know, he's not trying to desperately get at little Timmy's food.

We've got some catification here, some high areas, and some various different toys and challenges. Yeah, you've given me some wonderful answers coming in there. OK, so what other elements should we be discussing?

What are we missing from this picture? What, what else should we be talking about for Chester? Who is feeding him?

Yes, that would be good to know, wouldn't it? How many feeders have we got as one owner doing it, or both? Are they communicating, properly?

Yes. Talking to those neighbours, absolutely, we'd want to be thinking, are they playing a part here, . Well, what else have we got coming through here?

Yeah, we probably want to take a look at these interactions between the cats, you know, get some behavioural help if we're concerned about this, for sure. Yeah, wonderful. Also talking about visitors and yeah, do not feed me cos again, isn't it?

Well, one of the first things that I would certainly want to talk to them about is weighing the food out. We've talked about this this evening. If the owner, if the owners are away and the neighbours are looking after the cat, well, we can pre weigh out some of that food for them.

Let's, you know, just make life easy. Make sure we've got follow up appointments booked before they leave, think about the, weight loss duration and certainly be available if there's problems, you know, be contactable by phone, by text, by, email, you know, really allow owners to get hold of you. So just in the last sort of couple of thoughts that we have, like many owners, COVID-19 really presented a problem for us and specifically with cats too who don't like coming to the practise, how can you help them stay on track if they can't visit?

Videos, phone and video chat, Zoom calls we've got coming in, yeah, wonderful. Yeah, tape measures, definitely they can do that at home, it's not as accurate as weighing, but we can certainly be keeping an idea, yeah, telemedicine, baby scales, definitely home visit, yeah, it's could quite possibly be a good option for them. I think you've absolutely nailed it, so yes, certainly when we weren't able to see cases at the practise we did a lot via Zoom luggage luggage scales of the cats in the box, yes, I totally agree.

Well, here is Chester showing you how he went about home weighing. He's literally just the best cat ever, isn't he? So his owners did do some positive reinforcement training to get him to stand on the bathroom scales like that, but I was super impressed with what they did with him.

So just so that you are fully aware, Chester did lose his weight very, very nicely, started at 9.1 kg and ended up at a really nice 5.9.

Yes, he could have lost a little more potentially, but my goodness, look at the difference. If. For me, there is no more telling thing than how close his paws are together.

We call the picture on the left a wide base, and he just looks so fantastic. Yeah. Everybody, I, I know how proud his owners are of him, and I am super, super proud of them too.

Or with the help of course with that courgette. So this evening has been so much fun for me, thank you so much, and sharing your knowledge not just with me but with everyone else on the call this evening is just such a good way of learning. Pet obesity is a really complex disease.

It's not just about getting the food right, is it? There's so many more elements to it. But I know from everybody's answers here this evening, you all have the skills and the knowledge, to really improve the quality of life for your patients.

And sometimes you do just have to think outside the box or maybe that washing basket. For the final time, it has been my absolute pleasure. Thank you so much for listening this evening.

Georgia, thank you so much for your time this evening and thank you for the fabulous handling of the chat box. And as you can see, we have got Fantastic, comments coming through and great thanks to you for not only presenting this session, but we also got the similar things in the last session. So thank you so much for, what is absolutely an essential part of any veterinary practise, but you have made it so much easier and so interactive that people can look forward to doing this, which is fantastic.

Thank you. Oh no, well, thank you, and all your comments are absolutely wonderful. Thank you so so much.

And let's not forget a big thank you to our sponsors tonight, Royal Cannon. We really do appreciate their support, in sponsoring these webinars so that we can bring them to you. A little bit of housekeeping before we go on to a couple of questions.

Please don't forget that tomorrow night, you can join us for the 7 to 9 session on exotics. We have got some wonderful speakers lined up, and, it promises to be a really, really great session. And again, fabulous learning.

So do join us tomorrow night for the 7 to 9 session on exotics. Back to tonight, Georgia. We've had a couple of questions coming through relating about dry versus wet food for diets and especially for cats.

Yeah, sure. So, for cats in particular, we know that pet owners do prefer to feed some wet and some dry, but there are also some advantages. We try certainly and encourage wet and dry, mainly because, I mean, especially when we're thinking about obesity, the risks of urinary disease of some sorts is just mitigated a bit more if we can get lots of fluid movement through them.

So I personally, for cats, would always think about some wet and some dry. For dogs, it's a little bit different. Dogs, there isn't such necessity unless you want a, a much bigger volume, in which case wet food is great for them.

And then to sort of counter that, when we've got lots of dry food, that we can get them to work much better for it. We can use it as treats and split it up much more. So it's really, the species that you're dealing with, but also the pet's preference.

I know many cats that just will not entertain wet food. And, OK, fair enough, we can just give them dry food, but maybe we could add water to their dry food or get them a fountain and increase water intake that way. So yeah, it's a decision to be made maybe case by case.

Fantastic. You refer a lot to, to the aids and things that you use, the, the graphs and the charts and the weight charts and everything else. Can you just run through us?

We've had quite a few questions from people asking, where do I get this chart and how do I get that? And where do you recommend people go and look for their resources to help them with this? Yeah, sure, absolutely.

Well, all the body condition score charts can be obtained from Royal Canon. So either within your country or if you are in the UK, you will have a veterinary business manager from Royal Cannon that can definitely supply that information to you. So yeah, Royal Cannon would be the best place to start for that information.

I don't think I use the growth charts in this session, but certainly in the last session when I was talking about growth charts, they can be accessed from Waltham.com. They're a free, free resource that you can get hold of there.

Fantastic. Couple of questions coming through relating to, weight loss. Specifically when using an animal's normal food, either because the client is reluctant to change diet or, whatever their reasons are.

And then once they've lost weight, how to maintain that weight loss on so-called normal food. Yeah, there's two big things there really. The first one is weight loss on a, you know, in inverted commas normal food.

The problem with that is that even light diets are just not balanced for weight loss and so you risk nutrient deficiencies by doing it. If you've got an individual with a body condition score of 6, which is around 10% above ideal weight, you can use light diets, reduce them by 10%, but you can only do that for around 8 weeks before those nutrient deficiencies start kicking in, so short term only. So as far as what owners do, when they don't want to buy the weight management food that you're recommending, for me it's pet first.

There may be cheaper options out there of a weight of a specialist weight management diet, and maybe that is the compromise that they use a different product for that individual. When it comes to post weight loss, we know that they do much better, in fact, they're 20 times less likely to regain their weight if they stay on the food that they lost the weight from just is fed at a higher amount. The problem with going back to, again, a normal food is that you will put less in the bowl because per gramme it's higher calorie.

So then you get much more food seeking and you get probably much more in terms of owners giving treats cause they feel bad, it's such a small portion and that sort of thing. So I would always recommend whatever they use during weight loss to use that during maintenance as well, and then hopefully we can stop any rebound weight gain. Fantastic.

Last question for you. What do you think about specific products for losing weight rather than just manipulating diets? I think that there are many people an awful lot cleverer than I am, that have designed these specific product that, you know, that have designed and formulated, these sorts of diets.

And so I would very much put my trust in the science, as far as weight loss goes. I think trying to do weight loss in a The other way with sort of, you know, adding this or taking out that, you know, removing things from existing diets doesn't really work. And it's so hard to deliver complete and balanced nutrition that we really want a product that does all that work, all that hard work for us that has been tested, you know, ideally in those feeding trials so that we can rely upon it.

And I certainly don't like, recommending anything that I don't feel full trust in. So that's why I would be looking for the specifically formulated diets. I think that's a fantastic point there that, that you've made that I'd like to just highlight is, is you have to have trust in it.

You have to have researched it yourself. It's, it's probably not fair, for want of a better description, to be recommending stuff to clients that you yourself either don't believe in or haven't researched. Absolutely, couldn't agree more.

Fantastic. Folks, that's all we have time for on this session. Once again, it is my absolute pleasure to thank Georgia Woods, for her time tonight and for sharing her magnificent knowledge with us and your obviously great passion for this subject.

So Georgia, thank you so much for your time tonight. You're very welcome. Thank you.

To everybody who attended tonight, a big thank you to you as well. Remember that we have recorded these sessions. So if there was something that you missed that you want to go and look at again or a table or something like that, they'll be up on the website in the next 24 to 36 hours.

And you can go back and you can stop it and start it and rewind it as much as you want to. So, go and have a look and any sessions, for the virtual congress that you have missed, they will also be up and, you can go and have a look at all of those. So, to Dawn, my controller in the background, thank you very much and, Kyle for sharing the screens and making all that happen.

Thank you. And from myself, Bruce Stevenson, it's goodnight.

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