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OBESITY

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Obesity is a condition of excess body fat.


Body weight 10-20% above the ideal weight for that breed, sex and species.
It is the most common nutritional disorder in veterinary medicine with reported
prevalences of 25-44% in dogs, 6-12% in cats

Common or simple obesity


Refers to adipose tissue that occurs in a normal body distribution
Dystrophic obesity
A form of obesity wherein canine patients with hypercortisolism often have fatty
deposits over the dorsum and intraabdominally
2 Types of Common Obesity
1. Hyperplastic obesity
- due to excessive number of adipocytes, may have a genetic component and
is associated with overeating early in life
2. Hypertrophic obesity
- due to increased fat cell size; it usually occurs in adult life ad is believed to
be more prevalent in veterinary medicine

Identification of obesity is dependent upon subjective evaluation of body fat


stores
-can be accomplished by palpation over the rib cage
*ribs obscured by subcutaneous fat are indicative of obesity
*ribs readily visible without palpation suggest that the animal is too thin

Conditions that may be confused with obesity include:


o Generalized subcutaneous edema (anasarca)
o Abdominal distention due to any cause
edematous subcutaneous tissue will generally pit upon compression,
in contrast to the loose feel of subcutaneous fat
Pathophysiology: Development of obesity
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Caused by prolonged caloric intake in excess of body needs
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It may be due to overeating, reduced physical activity or both
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Genetic, endocrine, and social factors
Obesity develops in two stages:
1. First stage (the dynamic stage)
-body fat accumulates due to excess caloric intake
-the pets diet contains an excess number of calories during this stage
2. Second or static stage
-food intake is balanced by energy expenditure
-the obese sedentary dog may consume relatively few calories

Food intake
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Under control of the feeding and satiety centers of the hypothalamus


which determine a set point for body weight

Affected by psychologic factors, nutrient type, metabolic/endocrine


diseases, food availability and palatability, social factors

Boredom, idleness, and nervousness increase food intake in humans


and may have similar effect in animals

Commonly Identified Predisposing Pathologic Conditions:


Hypothyroidism and hyperglucocorticism
Cerebral/hypothalamic brain lesions
Insulinoma

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Genetic Predisposition to Obesity


Increased incidence in:
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Cocker spaniels
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Labrador retrievers
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Cairn
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West highland
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Scottish terriers
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Collies
Low incidence in:
o Boxers
o Fox terriers
o Sealyham terriers
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Females more commonly obese than males


Neutering has been associated with an increase in body weight
Increased incidence with advancing age of the pet due to reduction in basal
metabolic rate and physical activity
Castration - reduced activity, increased fat production
Spaying (occasional cases) result in marked obesity
Hormonal imbalance high FSH, low serum estrogen levels

Effects of Obesity
ORGAN

EFFECT OF OBESITY

General

Lethargy, irritability, fatigability, heat intolerance, inactivity,


increased risks with anesthesia and surgery, technical
difficulty with many diagnostic and therapeutic procedures

Musculoskeletal

Arthropathies, metabolic bone disease

Cardiovascular

Increased cardiac workload, myocardial fatty deposits,


myocardial hypoxia, arrhythmias

Gastrointestinal
Endocrine

Increased risk of pancreatitis and hepatic lipidosis


Glucose intolerance, increased risk of diabetes mellitus

Respiratory

Dyspnea, alveolar hypoventilation, exacerbation of any


respiratory disease

Immune

Increased susceptibility to infection, delayed healing

Reproductive

Dystocia, infrequent cycling, reduced reproductive


efficiency
Diagnostic Plan

Clinical Diseases Predisposing to the Development of Obesity


Disease

Suggestive clinical
signs

Laboratory findings

Special tests

Hypothyroidism

Lethargy, alopecia,
bradycardia,
thermophilia,
somnolence
hypothermia

Nonregenerative
anemia

TSH response test

Hypercortisolism

Polyuria/polydipsia,
Stress leukogram,
pot belly appearance, hyperglycemia, UTI
thin skin, alopecia,
hepatomegaly

Cortical /
hypothalamic lesion

Neurologic deficits

Insulinoma

Weakness, seizures

ACTH response test,


dexamethasone
suppression test
Neurologic exams, CSF
tap

hypogylcemia

Amended glucoseinsulin ratio

Symptomatic therapy

Warning the client about the complications of obesity


Reviewing the feeding regimen/food type used
Nutritional counseling

**Complete program for obese dogs are:


-client education, increased physical activity, reduced caloric intake
1. Client Education
o Emphasizing the negative effects of obesity
o Designing a program for recording daily exercise, food intake, and daily weights
at home
o Setting a reexamination schedule
2. Increased Physical Activity
Factors:
o Basal metabolic rate
o Calorie utilization from meal intake/digestion
3. Reduced Caloric Intake
REDUCING DIETS
Diet

Caloric Density (kcal ME)

Canine RD
Canine Cycle 3

330/can, 186/cup dry


355/can 257/cup dry

Fit n Trim

270/cup

Canine low-fat diet


lb cooked lean ground beef
cup uncreamed cottage cheese
2 cups carrots
2 cups green beans
1.5 tsp dicalcium phosphate
Vitamin-mineral supplement

250 lb

Diet

Caloric Density (kcal ME)

Feline R/D

350/can

Feline low-fat diet


1.5 lb cooked liver, ground
1 cup cooked rice
1 tsp vegetable oil
1 tsp calcium carbonate
Vitamin-mineral supplement

587/lb

Other Treatments
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Corticosteroids increase food intake


Thyroid hormone increase BMR and promote weight loss
Appetite suppressants (central acting amphetamine derivatives, peripheral acting
hormones, prostaglandins)
Centrally acting compounds
Amphetamine
Fenfluramine
Used for weight reduction in dogs without effect
Peripherally Acting Agent
Citric acid analog
Theochlorocitric acid
Appetite suppressant that induces satiety by slowing gastric emptying time
*Fenfluramine and Cholestyramine
- inhibit fat absorption (but no evidence of effectiveness in dogs and cats)

References:
Anonymous:http://www.animalworldnetwork.com/bobdomanpol.html
Ettinger. Veterinary Internal Medicine, pp 70-71
Lorenz, M.D. et at: Small Animal Medical Diagnosis, pp 98-106, 1987