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Exercise/Activity

Research in humans has shown that combining caloric reduction with exercise offers the best chance of successful and sustainable weight loss.57,58 Physical activity provides several potential benefits including preservation of lean muscle mass, increased caloric expenditure, and promotion of behaviors that aid in sustainable weight loss.59 Although evidence that exercise will enhance weight loss outcomes in pets is preliminary, data from humans suggests that increased activity could have a positive impact on weight loss in pets.40,60

Physical activity differs between dogs and cats. Assess and discuss with the client any pet and/or client physical limitations, client schedule, expectations and goals, possibilities, and limitations (e.g., pet sitter/daycare availability, activity options, adverse weather conditions).

Assess any comorbidities that may affect tolerance and timing of implementation of a physical activity program. Once a patient is deemed healthy enough to undergo an exercise program, design a plan based on endurance, intensity, and type of exercise. For pets with limited mobility, consider either low-impact exercise alternatives (such as swimming) or consultation with a rehabilitation therapist.

Factors to consider when formulating a plan include who will be involved (e.g., client, veterinarian, rehabilitation therapist, referral) and documenting activity (i.e., time, intensity, caloric expenditure, etc.). Use that information along with weight change to adjust the feeding and/or exercise plan as needed.

Evidence is lacking to describe an ideal exercise program for dogs. With the exception of walking, caloric expenditures for various forms of exercise in pets is largely undocumented. One approach for an obese dog with no orthopedic restrictions is to start with a 5 min walk three times/day, if possible. Increase gradually until either the client’s or pet’s limit is reached or once a total of 30–45 min of walking/day has been achieved.57

In general, most dogs expend about 1.1 kcal/kg/km at a brisk walking pace of 10–10.5 min/km.61,62 A 45 kg dog will burn about 240 calories after 4.82 km at that pace. Walking at a slower pace also has health benefits, although the benefits are difficult to quantify because of lack of current research. Use the above-described estimates to calculate suggested exercise by either duration or distance and incorporate that into the weight-loss plan. Without similar guidelines for other types of exercise, documentation of activity combined with more frequent weight monitoring may aid evaluation of other exercise protocols.

Introducing physical activity in cats can be challenging. Recommendations focus on environmental enrichment to encourage activity and modify behavior as summarized in Table 3. Hunting and stalking simulations may help motivate physical activity in cats. Sources of further enrichment ideas and activities are available and have been summarized in Table 4.63

TABLE 3: Issues Impeding/Preventing Weight Loss and Possible Solutions

 
Issues Possible solutions
Pet factors
Looks hungry/begging
  • Explain nutrient and calorie needs are met and that the begging is behavior, not nutritional or hunger-related.
  • Offer social or activity substitute (e.g., play, groom, walk, offer affection).73
  • Distribute a portion of the diet as treats instead of meals.
  • Divide food into more frequent, smaller meals.
  • Use food as salary the pet must earn.
  • Provide environmental enrichment.
  • Use food balls and food puzzles.
  • Place food to encourage exercise (e.g., cat tree/fetch).
  • Choose low-calorie treats (e.g., low-starch vegetables).
  • Remove pet from human feeding areas.
Misbehavior (trash raiding)
  • Increase physical activity and environmental enrichment.
  • Partner with client in solution building; set realistic expectations.
Nocturnal vocalization
  • Explain feline nocturnal feeding behavior.74
  • Change feeding management (night, later feeding, set automatic feeders for night).
  • Provide food toys/hidden food search.
Insufficient exercise
  • Encourage social groups for clients to relate to each other and promote exercise (e.g., dog walking groups, online communities).
  • Explore possibilities for day care, pet sitter services, hiring neighbors or teens.
  • Suggest creative ways to exercise when hot/cold weather interferes.
Multipet household with food sharing/ stealing
  • Explore separate meal feeding options.
  • Change food for all pets if possible.
  • Offer food puzzles to slow down and separate feedings.
  • Separate pets based on their physical abilities or size differences (e.g., food box with small hole for small cat; cat food high up, not accessible to dogs).
  • Use products that restrict crate access based on a magnetic collar.
Pet doesn’t accept new diet
  • Provide food alternatives with different textures and moisture content.
  • Use treat allowance of up to 10% of the overall calories of the diet as a palatability enhancer.
  • Gradually introduce a new food over ≥ 1wk.
  • For cats, offer the new food side-by-side with the current diet, with gradual removal of the usual food.
  • Avoid offering alternatives if the pet skips a meal; however, do not allow cats to go longer than 24 hr without consuming any meals.
Weight loss plateau
  • Inform clients that metabolic adaptations may result in slowing of weight loss and adjustment of the feeding plan will allow for weight loss to resume.75,76
  • Educate clients about necessary adjustments when energy expenditure changes to avoid repeated cycles of weight gain and weight loss.
  • Reassess exercise expenditure and recommend necessary changes.
  • Reassess/adjust caloric intake.
  • Consider water therapy/physical activity program, especially with pre-existing medical problems affecting exercise tolerance.
Client factors
Client frustration and fatigue
  • Extend recheck appointment length to allow greater support.
  • Identify and address specific frustrations.
  • Offer more frequent or intense coaching.
  • Be empathetic and nonjudgmental.
  • Acknowledge the difficulty of weight loss.
  • Encourage use of support groups.
Client resists new diet choice
  • Discuss preferences of food type and find compromises that meet client needs.
  • Educate and inform client about food myths.
Client guilt
  • Explain food-seeking behavior is often attention-seeking behavior.
  • Continue education about health benefits of weight management.
  • Explain that dogs develop stronger bonds with people who walk them than with those who provide food.
Nonadherent/ noncompliant household members
  • Offer methods to premeasure all food and treats for the day.
  • Identify specific impediments to adherence and offer specific solutions.
  • Consider multimodal methods (handouts, websites, emails, face-to-face meetings) for emphasizing the specific impact of excess BW on patient.
  • Engage entire family if nonadherence is suspected.

BW, body weight.

TABLE 4: Websites for Additional Information

 
Website URL Information on website
American Animal Hospital Association www.aaha.org
https://www.aaha.org/professional/resources/library/
GuidelinesTerms.aspx
Nutritional assessment guidelines; canine and feline life stage guidelines; nutritional assessment tools.
American Association of Feline Practitioners www.catvets.com Feline life stage guidelines; feline behavior guidelines; feline environmental needs guidelines; environmental enrichment tips.
American Veterinary Medical Association https://ebusiness.avma.org/EBusiness50/
ProductCatalog/
ProductCategory.aspx?ID=132
Client brochures, including “Your Pet’s Healthy Weight.”
Association for Pet Obesity Prevention www.PetObesityPrevention.org Weight loss tools, pet food information.
Association of American Feed Control http://www.petfood.aafco.org/Labeling
LabelingRequirements.aspx
General information about pet food label regulations;
Officials (AAFCO) http://www.petfood.aafco.org/
Presentations.aspx
pet food regulations label review checklist, including specific term definitions for weight management and calorie claims (see part IX, pages 169–200).
Catalyst Council http://catalystcouncil.org/resources/
health_welfare/
List of links and resources, including environmental enrichment and exercise ideas for vets and cat owners.
Indoor Pet Initiative www.Indoorpet.osu.edu Indoor pet initiative to increase environmental enrichment.
Partnership for Healthy Pets http://www.partnersforhealthypets.org/
practice_resources_overview.aspx
Practice resources and tools.
Pet Nutrition Alliance http://www.petnutritionalliance.org/
About_Us.aspx
Comprehensive nonbranded site providing tools and nutrition resources for health care professionals and clients
Texas A & M University http://www.vetmedicine.org/vetmednet/
index.php?pageid=5013
Weight reduction calculator.
World Small Animal Veterinary Association http://www.wsava.org/WSAVA/media/PDF_old/WSAVA-Global-Nutrition-Toolkit_0.pdf Nutrition toolkit; simple and extended diet history form template; pet food selection handout, including how to select a pet food.
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