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While we’re all so hot and heavy on the topic of pain, I thought it might be an opportune time to discuss the issue of pain relief when it comes to chronic arthritis and orthopedic injury. But this time I’m not going to wax poetic on the merits of Metacam or write with revolutionary zeal on the miraculous mix that is Rimadyl and Tramadol.

No, today I think I’ll dedicate to the phenomenal power of “simple” weight loss. Note that I did not modify this method with a descriptor devoid of quotation marks. And that’s because you and I both know that weight loss is never easy—not in real life, anyway.

The reality, however, is that weight loss can be as effective as medication in relieving the pain of orthopedic injuries—even more so when a pet is obese. Even surgery is often no match for the analgesic properties inherent in the diminished strain on joints that comes with weight loss.

In fact, I had a vet surgeon tell me this week that he’s as evangelical on weight loss as he is on orthopedic surgery—especially when it comes to cruciate ligament tears, hip disease, chronic medial patellar luxations and other joint ailments. When a pet is 20% overweight or more, he explains that appropriate weight loss will reduce the pain on a level commensurate with a $2500 TPLO surgery (cruciate repair) or an $8000 total hip replacement.

Consider this entry all this week’s most popular posts rolled into one. Here’s why: You can actually get much further when it comes to saving yourself money (not to mention avoiding your next “inevitable” veterinary nightmare) by investing time and energy in the painful (for us) pain-relieving process of weight loss.

Yet I still can’t talk most of my clients into accomplishing the obvious. Description of quantities fed typically come in the guise of hand gestures: “Doc, she only eats this much.” And most claim to assiduously shun all treats. As to exercise, they’re typically more forthcoming: “She’s a couch potato, Doc, what am I supposed to do?”

Contrary to my previous posts on this subject, I have recently adopted a more empathetic stance on the issue of obesity when it comes to certain pets. I do understand that some pets are just “born to be fat.” But that doesn’t mean that there’s nothing to be done about it.

Cutting food rations, switching to a higher quality diet, pain control (through drugs and/or nutraceuticals) and adopting a structured exercise regimen are all necessary components for the seriously weight challenged. In fact, I have yet to meet a patient who did not lose weight when remanded to my care for a month.

My most recent success was an obese, double-cruciate-afflicted Shiba who lost twenty of his sixty pounds while under our roof. He can walk now, whereas in the early days of his stay he had to be slung around with a towel wrapped under his burgeoning belly.

In extreme cases like this, it’s either emergency weight loss or euthanasia. Sad to say that in spite of such dire warnings, client compliance is never a given. Would that everyone had the funds to mitigate pain through meds and surgery, but when all else fails or can’t be managed financially, tried and true weight loss measures are always there to make life livable again.

Comments
Well, I can't really speak to the power of weight loss on pain control, but I can say what a difference it can make in energy. I’m a true believer after my experience this year. Two of my three cats were overweight. They both already ate the lowest calorie dry food I know of (prescription) and I felt I couldn't cut their portions as they became quite grumpy when I did. With the food recalls I became more interested in pet nutrition. What I read convinced me it was time to (1) help them loose weight, and (2) get them off the crummy dry food they were eating with a large portion of it's protein coming from grain.

I selected a high protein, grain-free canned food. I knew how much they weighed. And because they were never free fed, I was able to calculate approximately where their metabolism was (quite a bit below the 40kg/g of weight I have seen used as a guide). I figured out how much they should weigh and extrapolated out the amount of calories required to get to that weight and maintain. I verified the information with our vet - who was very impressed that I could calorie count for our cats.

It took about 4 months for one of the two to loose 1.5 lbs and get to his target weight of 15 lbs (both the cats loosing weight are big boned cats). Interestingly enough he continued to loose weight so I have had to increase his calories to maintain now. I think this shows the power of higher quality foods.

Our other cat started at 18.5 lbs and had a target of 16 lbs (ideally his target is probably closer to 15 lbs but I'm not sure whether he will get there or not). He has almost reached his target after 5 months. I've noticed just recently that he seemed to be getting hungrier so I also increased his calorie intake just slightly - and that has not stopped his weight loss. I have noticed a significant change for him. He is 8 years old and in comparison to when he weighed more, he seems almost kitten like in energy. He darts around the house, plays, etc. So, although he didn't have a pain issue to deal with, the weight loss made him so much more active. I once read in a vet's book that she didn't concentrate so much on the exercise for cats that are overweight as the increased energy and play would come naturally as they lost weight - for my cat she is 100 % correct. And if I can extend their lives, so much the better.
# Posted By Jenny | 11/3/07 9:55 AM
Oops - meant to say 40 kcal/kg body weight above.
# Posted By Jenny | 11/3/07 9:56 AM
I have a former coworker who adopted a dog who was brought in for euthanasia because she couldn't go up or down the couple stairs to the backyard and was having accidents in the house. She was a 10 year old, 110 pound yellow lab.

A reasonable amount of food and simple walking (only around the yard at first because that's as far as she could go) melted weight off that dog like nobody's business. She is down to about 65 pounds and has had both her knees fixed (she came with one torn cruciate, and then tore the second the night before her scheduled surgery). She looks like a completely different dog. She went from being a dog who could hardly walk to a dog who almost never stops bouncing. She got a whole new life just from losing the weight.
# Posted By katie | 11/3/07 10:57 AM
Fat pets is one of my pet peeves. In a go round with family about their obese dogs I was told by my father-in-law that he didn't care if it shortened their lives, they would at least die happy. Now there's some screwed up logic for you!

My husbands grandmother had a pom that weighed 13 lbs and eventually died from complications relating to the overeating. It was very sad but she killed that dog with her "kindness" from overfeeding. She was only 4 years old at the time.

Some people just don't get it and I honestly think others are just to lazy to put in the work.

Victoria Stillwell (From the show It's me or the dog.) had a great special on Animal Planet recently about fat dogs. I hope they repeat it alot.
# Posted By Marie | 11/3/07 12:25 PM
I'll second the motion for quality moist foods for cats. I have a couple of 4 year old littermates, male and female, that are roughly the same size. They are brother and sister and the boy, Thurston, is slighly larger in frame. When Thurston went in for dental work due to resorptive lesions, I was told that he should weigh a pound more than his 8 pound sister. How much did he weigh? 16 pounds! Due to the removal of 9 teeth, I was told to put him on a strict diet of canned food and no more free feeding the dry, at all. He has easily reached the 9 pound mark and Gookette has her brother back.

One other thing to consider with canned cat food...water intake. Thurston, like most cats, does not have a high thirst drive. Since he is eating canned, along with a bit more water thast I add to it, the pee balls in the litter are a lot bigger and I think the proper hydration is helping his energy levels in addition to the weight loss.

As far a RX diets...this isn't the first place I have hear that the weight loss RX diets don't work as advertised.

With dogs, I think a lot of people use the excuse of "at least he'll die happy" because they don't want to unglue themselves from the couch themselves. Most of the overweight dogs that enter our hospital have an uncanny resemblence to their owner. Funny how that works ;)
# Posted By Brian Hewitt | 11/3/07 4:03 PM
According to the packaging, Psycho Kitty "should" receive a cup of food a day. Okay, she has a very slender Siamese type frame. She's also a very active kitty, part of the reason we call her Psycho Kitty in the first place. On a cup of food a day, she went from six pounds as a one year old to twelve pounds in just a couple months. Needless to say, her rations were cut as soon as we realized how much she'd gained! She now gets 1/3 cup twice a day, plus small rewards of cooked poultry or cheese for obeying commands (come, jump up, jump down, sit, beg). As an added incentive for her, she gets fed on top of the refrigerator, meaning two sizable jumps every time she wants to eat. We also walk her on harness and leash several times a week. She's just over three, spayed, and acts she's still a kitten.
# Posted By MeriGray | 11/4/07 1:43 AM
I would love it if you could do a post on feline nutrition generally, or let us know how to get that information. I seem to have the opposite problem -- trying to put weight ON cats. I just lost a too thin IBD kitty. I'm about to adopt a hyperthyroid kitty from a shelter who needs to gain weight now that she's started on the meds. You can feel her spine from her days of being abandoned.

I don't mind cooking for them if I knew what to cook and in what combination. I've read that they need certain nutrients but I don't know which or how many. I have no idea what is the right amount of food or calories to feed my normal big orange tabby, who is 14 lbs. The vet said he's not obese for his size frame (he has huge paws) but I don't want him to be overweight and have problems with diabetes, etc, as he gets older. I buy them the best non-grain canned pet store pet food I can find. I just can't find a decent article or book that tells me how to feed them enough, without too much, and what human foods are OK or not ok.

P.S. You would not believe (or maybe you would) how many obese adult cats we've seen at the shelters lately. It is so sad. Hopefully their shelters can get them back down to normal weights.
# Posted By Debby | 11/5/07 1:10 PM
Hi Debbie - I had posted above about my two cats loosing weight, but I also know what you mean about trying to keep weight on. My third cat was diagnosed with IBD and pancreatitis in 2004. You might try joining the yahoo feline IDB group http://pets.groups.yahoo.com/group/FelineIBD/
I've been a member for a few months. One thing that is so evident from listening to people's stories there is how individual cats are with what they can tolerate for food and what they can't. Peaple feed a mix of raw, canned, some dry - in fact my cat is one of the very few that eats prescription dry. I've tried over 5 months to switch to canned but when I reduced his medications recently this was the only food I have found that he can tolerate. But given a choice of prescription dry and a higher dose of prednisolone plus mirtazapine, I'll take the dry food. Iif you are interested in doing raw for your cat, they are very good at sharing recipies, etc. It is a very active group, and a good group of people.

Good luck and I hope to see you post there.
# Posted By Jenny | 11/5/07 7:20 PM
Thanks, Jenny! I did lose my poor kitty a week and a half ago to intestinal lymphoma, but I will go on over and see if I can offer any advice, or see if anyone has had similar experiences to ours. Thank you so much!!
# Posted By Debby | 11/6/07 9:22 AM
There's an old saying that if your dog's overweight, you're not getting enough exercise, and boy, ain't that the truth. I have rheumatoid arthritis, and I'm grateful that my two dogs have kept me moving through the onset of this disease, instead of slumping on the couch like I would sometimes like to do. I know the twice daily walks have kept me from loosing more joint function than I have; and I'll do it for them, but without them I think the list of excuses not to walk would be looooong. I also wanted to put a suggestion out there about weight loss. My boy can eat huge amounts of food and just burn it up (hello testosterone!). But my girl, on the same exercise schedule, has been hard to keep the weight were it should be (boy, can I identify!). I feed a high quality, raw dehydrated diet supplimented with fresh stuff from my grocery store, but I felt like she was getting so little to eat; she was always hungry and had started getting a little bitchy (no pun). So I found some organic, salt free, BROWN rice cakes and started crumbling this in her food so that she had a larger portion, but very few more calories. I think those cakes are around 50 cal each, and she only gets about 1/4 a cake per meal. And I just use a little extra water when rehydrating the rest of the food. I also cut back by about half on the dietary enzymes/probiotics suppliment I use, since I didn't think she needed any help digesting her food. ;-) I'm also careful to take into account the amount of treats she gets on training days. Anyway, that's what worked for us. . . Now if I could just get those last extra pounds off of me! I bet that would work wonders for me too!
# Posted By Cardimom | 11/6/07 11:38 AM
Hi Debby. So sorry you lost your little friend. Any advice you can offer would be helpful.
# Posted By Jenny | 11/6/07 7:02 PM
I've only just discovered your blog (which by the way is a great read). I have a 10 year old Australian Shepherd, that is 23 inches tall (he got the giant gene in his litter) and until 2 years ago actively competed in Dog Agility. His arthritis set in early (3yo) due to a long undiagnosed bout of pano when he was a pup. However, he was able to compete much longer than one would expect, with only occasional pain meds because he was and is a healthy, lean 55 lbs. Even now, with 2 young dogs to keep in line he only needs the occasional dose of Metacam and a monthly chiropratic visit.

I will keep reading. Great Blogging.
# Posted By Amy | 11/29/07 11:30 AM
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