In this VETgirl online veterinary continuing education blog sponsored by Purina® Pro Plan® Veterinary Diets, Dr. Ross Palmer, DVM, MS, DACVS, discusses the “dreaded duo” of obesity and osteoarthritis (OA) in dogs. He also offers optimism: how these comorbidities are utterly defenseless when pet owners and veterinary teams work together to beat them. Please note the opinions in this blog are the expressed opinion of the author and not directly endorsed by VETgirl.
Fighting the Dreaded Duo of Obesity and Osteoarthritis: You CAN Win the Battle
The dreaded—and dangerous—duo of osteoarthritis and obesity takes a huge toll on dogs and their families, prohibiting them from enjoying active time together and threatening the human-animal bond that is so important to the well-being of pets and their families.
I recently read a book that explored the meaning of the term “well-being” for the elderly human population. The book’s author posed the question, “Who can best assess well-being?” Just as families and physicians partner to care for elderly people, we as veterinarians and veterinary care teams can partner with pet owners to help promote well-being for arthritic, obese patients.
And what is “well-being” for dogs? For me, it is demonstrated by dogs that get excited when they interact with their human families and are laser-focused on the smells, sights or sounds of the world around them. They are happy and eager to pursue their whims, passions and fancies—be it keeping squirrels at bay in the yard, bird hunting or engaging in whatever activity appeals to them. We may not be able to precisely define animal well-being, but we know it when we see it.
Delivering quality of life and longevity
I love the idea of promoting well-being in pets. What could be more fun and professionally satisfying? It was through this lens that I re-read the results of the Purina Life Span Study (1), which revealed the benefits of feeding dogs to a lean body condition.
The study was conducted by Purina researchers and lasted 14 years. Forty-eight 8-week-old Labrador Retrievers—24 pairs of littermates—were enrolled. They were paired according to gender and body weight and randomly assigned to a control group or a lean-fed group. Dogs in the lean-fed group were fed 25% less food than their paired littermates and maintained in a lean body condition.* All dogs received the same 100% complete and balanced food; the only thing that was different was the amount. (Control dogs were fed ad libitum.)
Findings revealed that feeding dogs to maintain an ideal body condition over the course of the study helped extend their healthy years.
• The lean-fed dogs in this study had extended their healthy years by an average of 1.8 years longer than dogs in the control group.
• The lean-fed dogs also had a delayed onset of treatment for OA and other chronic conditions than dogs in the control group. The prevalence and severity of OA in the shoulder and elbow joints was also lower in the lean-fed dogs. At 8 years of age, the prevalence of OA in two or more joint types was 77% among control-fed dogs, yet only 10% among lean-fed dogs. (2)
The payoff: Restricted caloric intake may benefit BOTH quality of life and life span. If we don’t educate clients, many will not realize that by overfeeding their pets they are robbing them of both life quality and life quantity.
Defining the veterinary team opportunity
As we all know, the Internet contains accurate, useful information about pet care, as well as a wealth of misinformation for pet owners. The opportunity for the veterinary team is to build meaningful relationships with clients whose dogs are contending with the “dreaded duo” of obesity and OA and help them navigate their care. A good starting place is reviewing the Purina Body Condition Scoring System chart with clients so they can see what category their dog is in now and learn how they can help their dog reach a more ideal body condition.
Additionally, effective weight loss and OA management require a detailed nutritional plan:
• Feed to a lean body condition and do not feed free choice.
• Recommend an evidence-based therapeutic diet formulated for weight loss.
• Closely monitor the rate of weight loss (1% to 2% of body weight per week).
• After goal weight is achieved, switch to an evidence-based therapeutic diet with a high level of omega-3 fatty acids formulated for joint health.
Few of us can provide the support pet owners need to help their dogs lose weight and manage OA in a single 15-minute appointment. It takes time and dedication. But there is a silver lining: As clinicians, we can provide comprehensive weight management counsel and lifelong OA care to pets and owners who need our help. It is this time, dedication and follow-through that builds strong bonds between pet owners and veterinary health care teams.
Success story: Seeing the lean dog within
Grizz was a 10-year-old overweight Labrador Retriever with OA who struggled to walk across a room and a clear example of what it looks like to lack “well-being.” He’d had one failed extracapsular suture stabilization (Ex-Cap) procedure and one tibial plateau leveling osteotomy (TPLO) surgery. Grizz subsequently developed patellar luxation complicated by his preexisting OA and decreased mobility. His owner was considering yet another surgery. I advised rehab and nutritional management to help Grizz lose weight so he could be a better surgical candidate for me. I’ll admit that I was doubtful about this patient’s chances for successful restoration of his well-being.
Grizz started out at just over 43 kg (94.6 lbs) in mid-March 2015. Our nutritional services staff calculated his daily resting energy requirement (RER) and placed Grizz on a therapeutic weight-loss diet. Dietary adjustments were made based upon body weight monitoring. By the end of June, Grizz’s weight had decreased to just under 40 kg and he was beginning to show some signs of improved energy, stamina and interest in activity.
At this time, Grizz’s owner told me he’d like to take Grizz on a fall hunting trip. This meant multi-day hiking in altitudes of up to 10,000 feet or more. With visions of him struggling to walk across the tile-floored room just a couple of months prior, I wasn’t exactly optimistic about this prospect. Grizz’s owner sensed that and seemed to interpret it as a lack of interest on my part to help him. However, he was very motivated and understood that training needed to start immediately if there was to be any hope of meeting this ambitious goal. His question: If I couldn’t help, could I recommend someone who could?
I have to admit, those words hurt because I heard in them that he sensed I wasn’t willing to try. Nonetheless, I’m thankful for them because this alerted me to how my words may be interpreted differently than I intend. I saw the determination of Grizz’s owner and agreed to work with him and Grizz in hopes of achieving their goal. I worked with our physical rehabilitation team who placed Grizz on an incremental training program that included an underwater treadmill, a complex array of strengthening and stretching exercises, and various rehab modalities—the intensity of which resembled preparing for a marathon.
By late August, Grizz was down to just over 36 kg and, by the time of the hunting trip in November, Grizz had reached his goal weight of 34 kg (about 75 lbs). I am happy to report that he more than “survived” that hunting trip—he thrived—and it was one of many hunting trips to follow (all without ever having another surgery).
I had the privilege of watching a dog transform before my eyes and enjoy seeing him and his owner get their lives and their fullest relationship back: a true return to “well-being.” There’s nothing I have done in my career that has been more satisfying than that journey and others like it. I challenge you: Can you look at an obese patient with OA and see potential? Can you see the lean dog within? I couldn’t at first, but Grizz taught me what is possible.
What I learned from working with Grizz
Grizz and his owner taught me some incredible lessons that changed the way I look at co-morbid OA and obesity that others may find to be a helpful perspective.
1. Unchecked, the “dreaded obesity and OA duo” robs pets of life quality and quantity.
2. These dogs need a motivated pet owner and veterinary team who can see “the lean dog within” in order to win. Remember that sometimes the pet owner is more motivated than we know, but senses that we are not.
3. Don’t set the patient’s goals too low. If you believe it, you can achieve it.
4. Create a detailed weight loss and OA management nutrition plan and explain to the pet owner the importance of adhering to it.
5. When confronted with an overweight, arthritic dog, replace your initial response of discouragement or hopelessness with a response of opportunity—an opportunity to give the gift of well-being back to pets and their families. You just might discover a new passion in your career and in your clinic team!
I’m grateful to Grizz, his owner, and all of the pets and owners I’ve partnered with over the years to fight obesity and OA. They’ve shown me what dedication, grit and love truly look like.
1. Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs. J Am Vet Med Assoc. 2002 May 1;220(9):1315-20. doi: 10.2460/javma.2002.220.1315. PMID: 11991408.
2. Kealy RD, Lawler DF, Ballam JM, et al. Evaluation of the effect of limited food consumption on radiographic evidence of osteoarthritis in dogs. J Am Vet Med Assoc. 2000 December 1;217(11): 1678-1680.
*Lean or ideal body condition refers to the evaluation of body physique in pets as an indicator of their overall health and well-being, generally falling into three categories: too heavy, ideal and too thin.
Dr. Palmer is a professor of orthopedic surgery at Colorado State University College of Veterinary Medicine and Biomedical Studies.