Nutritional Risk Factors

The goal of the screening evaluation is to identify any nutritional risk factors from the patient’s life stage, medical/dietary history, or physical exam (Table 4). Once a nutritional risk factor(s) is identified, an extended nutritional assessment is recommended. Vulnerable life stages such as growth, gestation, lactation, and advancing age alter the patient’s energy and nutrient requirements. Previous or chronic medical conditions may have key nutritional factors to address when making new recommendations. Owners may use foods to administer medications or supplements, and dietary supplements may be a significant source of calories. Noncomplete or unbalanced food calories at >10% of a patient’s daily caloric intake dilute essential nutrients and provide excess calories. Unconventional diets should be assessed for nutritional adequacy and safety. Inadequate or inappropriate housing can contribute to stress or barriers that may cause changes in food intake.

Table 4

Nutritional Screening: Risk Factors as Determined by Life Stage, Medical/Dietary History, or Physical Exam
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Risk Factors

Check if present

Life stage with specific nutritional requirements (e.g., growth, gestation, lactation, senior, geriatric)


Altered gastrointestinal function (e.g., vomiting, diarrhea, reduced fecal quality, nausea, flatulence, constipation)

Previous or ongoing medical condition/disease

Currently receiving medications and/or dietary supplements

Calories from noncomplete and balanced foods >10% of total caloric intake (e.g., commercial treats, table foods, chew bones, foods for medication administration)

Unconventional diet (e.g., raw meat based, home prepared, vegetarian, vegan)

Inadequate or inappropriate housing

Physical examination

Body condition score < 4/9 or > 5/9

Muscle condition score with mild, moderate, or severe muscle wasting

Unexplained weight change

Dental abnormalities or disease

Poor skin or hair coat

New medical condition/disease

A BCS <4/9 or >5/9, MCS with any degree of loss, and unexplained weight change from the pet’s previous assessment should prompt an extended assessment. Dental abnormalities or disease may impact food intake, leading to anorexia, hyporexia, or dysrexia. Poor skin or hair coat quality may indicate nutrition-related abnormalities. New medical conditions or diseases may benefit from specific nutritional interventions (Table 8).

These guidelines are supported by generous educational grants from Hill’s Pet Nutrition, Inc., Purina® Pro Plan® Veterinary Diets, and Royal Canin®.