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Nutritional Assessment

Click here for a printable BCS/MCS chart.

Nutritional assessment should be a part of every visit to the veterinary practice and should use the entire practice team. Evaluation of the body condition score (BCS), muscle condition score (MCS), and nutritional factors can reveal a need for change in the feeding practice. BCS/MCS scoring is illustrated in here.56 Factors to be evaluated at each visit include animal, diet, feeding management, and environmental factors.56,57 Briefly, animal factors include age, physiologic status, activity, and disease processes. Diet-specific factors include type of diet (homemade versus commercially produced, raw or grain-free), amount fed, whether the food has been under recall recently, and supplements. Feeding management and environmental factors include the specifics of where and how a dog is fed.56,57

A complete nutritional assessment is detailed, should involve the entire veterinary team, and may involve a board-certified veterinary nutritionist. Nutritional assessment is a two-part process: (1) Screening evaluation is performed on every animal. Based on the screening, pets that are healthy and without risk factors need no additional nutritional assessment. (2) Extended evaluation is performed when one or more nutrition-related risk factors are found or suspected.

Because of the importance of a consistent practice team approach to nutritional assessment, recommendations, and protocols, there is benefit in identifying, training, and utilizing a nutrition ‘champion’ within the practice team. Standardized BCS and MCS results should be recorded along with the patient’s weight at each visit. Ideally, these data should be stored in a searchable medical records system.58,59 Obtaining nutritional information may require an extended consultation or additional data depending on animal, dietary, feeding management, and environmental factors.

The dog’s life stage will alter the approach to the nutritional assessment. As a puppy, the focus should include evaluation of the breed and size of the dog to allow for targeted nutrition for appropriate growth. Each visit should include a discussion on establishing an appropriate feeding schedule with consideration of diet, feeding management, and environmental factors. This discussion will continue in the young adult stage, with increased focus on the target weight, BCS, and MCS. The risk of weight gain with sterilization should be discussed when appropriate.60 It is noteworthy that 56% of dogs in the United States are overweight or obese.61,62 Emphasis should be placed on the importance of weight control and its effect on overall health. A study involving Labrador retrievers revealed that those who maintained their ideal weight through their life stages live an average of 15% longer.62 Clinical experience supports that this likely holds true for other breeds as well. The importance of trending the BCS, MCS, and weight will continue into the mature adult and senior life stages. MCS becomes even more important in the aging dog where the potential for reduced mobility exists.63 In the senior dog, there are often comorbidities that should be considered when performing the nutritional assessment.63

Once data from the nutritional assessment are obtained, all factors should be analyzed to devise a dietary action plan. This may result in a modification to any part of the diet including the amount of food fed or environmental factors related to feeding. In many cases, a modification is not required, and monitoring can be implemented. The frequency of monitoring will depend on life stage and will be more frequent in growing, lactating, pregnant, senior, service dogs, and dogs with a disease process. Pet owner education is paramount, as there is a wealth of information and misinformation available outside of the veterinary practice. Pet owners should be educated as to how to ensure the correct amount of food is provided, how to monitor BCS and MCS themselves, and risks associated with certain feeding practices.56,59 Because food intolerance can occur at any age, pet owners should be counseled to seek veterinary advice if the dog develops any abnormalities (e.g., gastrointestinal, dermatological) before changing food types on their own accord.64 The AAHA Nutritional Assessment Guidelines for Dogs and Cats are a definitive resource for evaluating the nutritional needs of canine and feline patients at each life stage.56

The 2019 AAHA Canine Life Stage Guidelines are supported by generous educational grants from Boehringer Ingelheim Animal Health USA Inc., CareCredit, Elanco Animal Health, Hill’s ® Pet Nutrition, Inc., IDEXX Laboratories, Inc., Merck Animal Health and Zoetis Petcare.