Download 2014 AAHA Weight Management Guidelines for Dogs and Cats

2014 AAHA Weight Management
Guidelines for Dogs and Cats
IMPLEMENTATION
TOOLKIT
Inside This Toolkit
Why Guidelines Matter.....................................................................................3
Understand the Guidelines’ Key Points.............................................................4
2014 AAHA Weight Management Guidelines for Dogs and Cats ...................5
Tip Sheet: Calculating a Pet’s Caloric Intake for Weight Management .........15
AAHA’s Model Protocol for Weight Management..........................................16
AAHA’s Weight Management Algorithm.......................................................17
Use Checklists to Ensure Consistency.............................................................18
Clarify Staff Roles and Responsibilities...........................................................20
Client Handouts..............................................................................................21
Talking Points for Partnering with Clients......................................................22
Resources from AAHA and the PNA...............................................................23
AAHA Standards of Accreditation
The AAHA Standards include standards that address
weight management. For information on how
accreditation can help your practice provide
the best care possible to your patients, visit
aahanet.org/accreditation or call 800-252-2242.
Free web conference available now!
Be sure to check out the 2014 Weight Management
Guidelines for Dogs and Cats implementation web
conference with Dr. Ernie Ward, DVM, available at
aahanet.org/webconf. Earn 1 hour of CE credit.
Why Guidelines Matter
Veterinary practice guidelines, including the 2014 AAHA Weight
Management Guidelines for Dogs and Cats, help ensure that pets get the
best possible care. From medical director to veterinary assistant, guidelines
keep your hospital staff on the cutting edge of veterinary medicine.
The 2014 AAHA Weight Management Guidelines for Dogs and Cats
is the most complete and medically sound compilation of updates,
insights, advice and recommendations ever developed. Those guidelines
help ensure all pets enjoy the benefits of assessment and management to
maintain a healthy weight throughout their lifetimes.
AAHA guidelines review the latest information to help veterinary
staff address central issues and perform essential tasks to improve the
health of the pet. In addition, AAHA guidelines define the role of each
staff member so that everyone on the health care team can work together
to offer the best-quality medical care.
Guidelines are just that: a guide established by experts in a particular
area of veterinary medicine. Guidelines do not outweigh the veterinarian’s clinical judgment; instead, AAHA guidelines help veterinarians
develop and carry out treatment plans that meet each patient’s individual
needs and circumstances.
Aligning your practice’s protocols with AAHA Guideline recommendations is a key step in ensuring that your practice continues to delivery
best-quality care. To support your dedicated efforts, AAHA is pleased
to offer this toolkit. In here, you will find facts, figures, highlights, tips,
client handouts and other tools you can use every day to implement the
recommendations of the 2014 AAHA Weight Management Guidelines for
Dogs and Cats.
In addition, AAHA and other organizations have committed to
providing a full suite of implementation tools, fact sheets and more
information through the Pet Nutrition Alliance (PNA, available at
petnutritionalliance.org/default.aspx). Page 23 of this toolkit highlights
just a few of the many resources you can find on the PNA website.
AAHA and other organizations are continually updating the website, so
check back often for new tools.
Thank you for helping to advance our shared mission to deliver the best
in companion animal medical care. Together, we can make a difference!
Michael T. Cavanaugh, DVM, DABVP
AAHA Chief Executive Officer
When selecting weight management products, as well as other types of products,
veterinarians have a choice of products formulated for humans and those developed
and approved for veterinary use. Manufacturers of veterinary-specific products spend
resources to have their products reviewed and approved by the U.S. Food and Drug
Administration for canine and/or feline use. These products are specifically designed
and formulated for dogs and cats and have benefits for their use; they are not human
generic products. AAHA suggests that veterinary professionals make every effort to use
veterinary FDA-approved products and base their inventory purchasing decisions on
what product is most beneficial to the patient.
3
Summary of Key Points
Weight management is an essential component of every pet’s health care plan.
Excess weight can reduce longevity and adversely affect quality of life. It is associated with skin and respiratory
disorders, renal dysfunction, an increased risk of metabolic and endocrine disorders, orthopedic disease and some types
of cancer.
The entire veterinary team should be knowledgeable about weight management, prevention of weight gain, weight
loss protocols, online information sources and client educational materials.
A thorough nutritional assessment is necessary for the practitioner to design a weight loss plan. Use the 2014 AAHA
Weight Management Guidelines for Dogs and Cats in conjunction with the 2010 AAHA Nutritional Assessment Guidelines for
Dogs and Cats to create your overall approach.
An effective individualized weight loss program is achieved with appropriate caloric restriction, diet selection,
exercise and strategies to help modify behavior of both the pet and client.
The clients’ and pets’ individual circumstances, family and environment will affect the details of the weight
management plan.
Home management is vital for weight control. Working in partnership with clients to create a plan that will work
with their lifestyle and abilities is essential. Keep in mind that what works for one client may not work for another.
Record the results of all examinations and ongoing evaluations in the medical record.
Maintaining an ideal body weight is a lifelong process that begins at the first veterinary visit, extending
for the life of the pet.
4
©Nailia Schwarz/Veer
2014 AAHA Weight Management Guidelines for Dogs and Cats*†
Dawn Brooks, DVM, Julie Churchill, PhD, DVM, DACVN, Karyn Fein, DVM, CSCS, Deborah Linder, DVM, DACVN, Kathryn E. Michel, MS, DVM, DACVN, Ken Tudor, DVM, Ernie Ward, DVM, Angela Witzel, PhD, DVM, DACVN
Abstract
Communicating and implementing a weight management program for dogs and cats can be a challenging endeavor for veterinarians,
but a rewarding one. An effective individualized weight loss program provides a consistent and healthy rate of weight loss to reduce
risk of disease, prevent malnutrition, and improve quality of life. Weight loss is achieved with appropriate caloric restriction, diet
selection, exercise, and strategies to help modify behavior of both the pet and client. This document offers guidelines and tools for the
management of weight loss and long-term maintenance of healthy weight. (J Am Anim Hosp Assoc 2014; 50:1–11. DOI 10.5326/JAAHA-MS-6331)
Introduction
Up to 59% of dogs and cats are overweight, making this the most
common nutritional disorder identified in veterinary practice.1–3,4
Excess weight can reduce longevity and adversely affect quality of
life.5–7 The hormones and inflammatory cytokines released by excess
adipose tissue lead to a state of chronic inflammation, the impact
of which is not completely understood at this time.8,9 Excess weight
is associated with skin and respiratory disorders, renal dysfunction,
and it increases the risk of metabolic and endocrine disorders (e.g.,
diabetes), orthopedic disease, and some types of cancer.7,10–19
Weight management, including obesity prevention and treatment, remains a challenge for veterinarians and clients alike.
Among clients with dogs defined as “overweight” by the veterinarian, one study showed that 39% of the clients thought that their
dogs were at an acceptable weight.20 Those clients are unlikely to
be aware of the negative impact excess weight has on their pets’
health. Additionally, some veterinarians struggle to find a tactful
and effective way to discuss the impact of obesity and importance
of weight loss.
The goals of these guidelines for dogs and cats are to raise
awareness of the negative health consequences of excess weight,
promote the prevention of excess weight, and offer guidelines and
tools for the management of weight loss and long-term maintenance of healthy weight. Although “weight management” may
also include dogs and cats that are underweight due to lifestyle or
medical causes, management of such cases can be complex and is
beyond the scope of this document.
An effective individualized weight loss program provides a
consistent and healthy rate of weight loss to reduce risk of disease,
From the Countryside Veterinary Hospital, Chelmsford, MA (D.B.); College of Veterinary Medicine,
University of Minnesota, St. Paul, MN (J.C.); Tender Touch Animal Hospital, Denver, CO (K.F.); Tufts
Cummings School of Veterinary Medicine, North Grafton, MA (D.L.); School of Veterinary Medicine,
University of Pennsylvania, Philadelphia, PA (K.M.); Hearthstone Homemade Program for Dogs,
Claremont, CA (K.T.); Seaside Animal Care, Calabash, NC (E.W.); and Veterinary Medical Center,
University of Tennessee, Knoxville, TN (A.W.).
Correspondence: [email protected] (D.L.)
prevent malnutrition, and improve quality of life. Weight loss is
achieved with appropriate caloric restriction, diet selection, exercise, and strategies to help modify the behavior of both the pet and
client. The success of any program depends on partnering with
clients to set expectations, promote client compliance and treatment adherence (compliance and adherence describe the degree
to which the client correctly implements medical advice and continues an agreed-on mode of treatment), and overcome challenges
presented by each pet.
Prevention
Because of the high prevalence of overweight pets and the health
risks associated with excess body fat (BF), prevention efforts
used by the entire veterinary team may positively impact pet
health. The most appropriate time for weight management and
intervention is prior to weight gain and the subsequent development of clinical disease. Maintenance of a healthy weight should
begin with the first veterinary visit including recommendations
for the following:
yy Puppy and kitten feeding
yy Evaluating body condition score (BCS) and how to adjust
feeding when BCS changes are noted at home, particularly
after either spaying or neutering21
yy Maintaining an ideal adult weight
yy Maintaining exercise and activity
yy Behavior training using interactive rewards as alternatives
to food
yy Educating clients about the limitations of pet food labels
and label feeding recommendations
The authors specifically requested that they not be told the identity of the sponsors until the
document was completed.
†
These guidelines were developed by a panel of experts to help the practicing veterinarian raise
awareness of the negative health consequences of excess weight, promote the prevention of
excess weight, and offer suggestions and tools for the management of weight loss and long-term
maintenance of healthy weight. This document is intended as a guideline only. Evidence-based
support for specific recommendations is cited whenever possible and appropriate. These guidelines
were sponsored by a generous educational grant from Hill’s Pet Nutrition and Zoetis.
*
AAFCO American Association of Feed Control Officials; BCS body condition score; BF body fat; BW body weight; MCS muscle condition score; RER resting energy requirement; OTC over-the-counter
5
2014 AAHA Weight Management Guidelines for Dogs and Cats
Monitor weight trends and proactively address weight gain
early at any BCS above the ideal. Adverse subclinical consequences
such as low-grade chronic inflammation are the most difficult to
perceive as a health issue, yet before clinical signs are evident is the
most appropriate time for medical intervention.
Puppies and kittens must consume food that meets their
requirements for growth to ensure adequate intake of critical
nutrients, such as protein, calcium, and phosphorus, until they
have completed skeletal growth.22 Instruct clients to monitor
puppies’ and kittens’ BCS q 2 wk. At the time of either spaying or neutering, there may be an increase in the pet’s appetite
but a decrease in its caloric needs.23–25 There should be nutritional
assessment at regular intervals postgonadectomy. If the growing
pet has a BCS higher than ideal, switch to a lower calorie puppy
or kitten food, eliminate other sources of calories, and emphasize
exercise and environmental enrichment. Either changing to an
adult food or weight-loss food before skeletal maturity is complete
is not recommended as that may not meet nutritional requirements for growth.
Seasonal changes may affect both activity and appetite.26
Temperature extremes often limit outdoor activities and decrease
daily caloric expenditure. Educate clients about diet and feeding
management adjustments that are necessary when energy expenditure changes to avoid repeated cycles of weight gain and weight loss.
Weight monitoring and prevention of weight gain is particularly important for dogs prone to obesity (e.g., Newfoundlands,
dachshunds, cocker spaniels, or any dog with low energy expenditure) and cats housed mostly indoors with minimal activity.4,27–29
Aging also affects metabolic rate and activity level.30–32
Nutritional reassessment at yearly exams will help to identify and
address weight gain as pets age. The greatest prevalence of obesity
has been identified in dogs and cats between the ages of 5 yr and
12 yr, so that age group may benefit from increased vigilance and
perhaps a diet change to a less calorie-dense food.
Begin by assessing the patient, the environment, and obtaining
a full diet history as detailed in the AAHA Nutritional Assessment
Guidelines fro Dogs and Cats.21 Identify all household and environmental factors that impact feeding management (i.e., current diet,
feeding schedule, treats, numbers and perceptions of household
members involved with feeding), exercise (current and potential),
and the environment (housing, environmental enrichment).21
Evaluate the pet’s current body weight (BW), BCS, and muscle
condition score (MCS) as part of the health assessment and for
determining healthy weight.21,33 Assessing the MCS along with the
BCS will establish a baseline from which you may monitor muscle
and fat loss, especially if there is either a comorbid condition (where
either the weight loss rate may be lower or the patient is at risk for
loss of muscle mass due to the catabolic impact of disease) or the
patient is losing weight too rapidly (resulting in loss of muscle mass).
Estimating the pet’s ideal weight helps determine the pet’s
caloric requirements and establishes a motivating goal. Some ways
to estimate a patient’s ideal weight include the following:
1.Historical. Check the medical record for the pet’s weight and
BCS history to determine whether it shows a previous ideal
weight that correlates to a BCS of 5 out of 9 or 3 out of 5.
2.Calculate the ideal weight from the current BCS if
historical weight information is not available. Each BCS
 5 (on a 9 point scale) or half of a BCS  3 (on a 5
point scale) is equivalent to being 10% overweight.34–37
For example, a 45 kg Labrador retriever that has a BCS
of 8 out of 9 is 30% overweight and its ideal weight is
approximately 32 kg (Table 1).
3.Use the percent BF that correlates with the BCS scores to
estimate ideal weight using the equation: [current BW 
(100  %BF)]/0.8.37 Note that lean mass is 80% of the
ideal BW, assuming 20% BF.
Although there is not an established criterion in veterinary
medicine, for the purpose of this document, the authors define
obese as a BCS of  8 out of 9 (or 5 out of 5). Although studies often do not differentiate overweight pets from obese pets,
health risks and clinically apparent disease seem greater in severity
as weight gain increases. Long-term studies of pets with various
BCS categories against controls are needed to verify that clinical
impression. All overweight pets suffer from similar, yet less obvious morbidities, and should be treated with as much urgency for
weight loss as obese pets.7
It is challenging to accurately determine ideal BW in obese
patients that exceed the BCS scale (i.e.,  5 out of 5 or  9 out
of 9, correlating to being  40% overweight). There is no proven
method for adjusting the calculation for severely obese patients,
and the above approach may cause an overestimate of the ideal
weight. Reassessing the patient as their BCS improves during
weight loss allows refinement and more accurate estimate of the
patient’s ideal weight.
Assess the Patient
In addition to a complete physical exam, the patient health assessment may include relevant laboratory and imaging studies as
appropriate to assess for comorbidities that may impact either
caloric needs or require additional management (e.g., exercise limiting orthopedic disease, metabolic/endocrine disorders).
Assess the Client and Feeding Management
Success for weight loss depends on the client’s willingness, interest, and ability to follow recommendations (i.e., adherence).
Assess the client’s readiness to change his/her feeding habits and
evaluate opportunities for changing the pet’s management and
lifestyle.38 Identify challenges the client has faced in the past with
Initial Assessment
6
feeding management to effectively tailor the plan to the patient
and engage the entire household.
Assess the Current Diet
The diet history can provide valuable information about current
caloric intake that can serve as a starting point for the weight loss
program and help the veterinarian anticipate potential challenges
to the weight loss plan (discussed in detail below). Collect information about total daily intake (i.e., varieties and amounts of foods,
treats, chews, and supplements; feeding management; and any use
of food to administer medication), with sufficient detail to account
for all calories ingested. Anticipate nutritional imbalances when
treats and human foods exceed 10% of the total caloric intake.21
Evaluate how food plays a role in the client relationship with
the pet, such as food used for training, nurturing, or bonding in
specific situations. Assess “nonnegotiables” lifestyle aspects that
the client seems either unlikely or unable to change and try to
incorporate some aspect of those aspects into the plan. Such compromises can help increase adherence and trust moving forward
with the weight loss program.
Designing a Weight Loss Program
Overall Approach
After the initial assessment is complete, formulate an individualized weight loss plan. The plan should include the determination
of the following:
1.Ideal BW
2.Caloric restriction
3.Food selection and treat allowance(s)
4.Feeding management and activity plans
5.Scheduled follow-up
Determine Daily Caloric Intake
The approach to determining the daily caloric goal for weight
loss depends on the presentation and history of the patient.39 Any
method of caloric restriction is merely a starting point and subject to individual metabolism. Regular monitoring is essential to
ensure healthy weight loss and allow for necessary adjustments
in caloric intake. Two options for determining the daily caloric
requirements for weight loss are the following:
1.Feed an amount to provide 80% of the current caloric
intake. That approach may be effective in patients that
are overweight and are at a stable weight with an accurate
diet history. However, if a pet is actively gaining weight,
a greater reduction may be required to promote effective
weight loss.
2.Calculate the resting energy requirement (RER) using
the pet’s estimated ideal weight then feed a percentage of
that amount. Although there is no established standard
reduction, feeding 80% of ideal-weight RER is effective
©AAHA/Kimberly lamb
Educate clients about diet and feeding management
adjustments that are necessary when energy
expenditure changes to avoid repeated cycles of
weight gain and weight loss.
TABLE 1
Summary of BCS Scales and Their Relationship
with BF and BW36,68–71
9 point scale
5 point scale
% BF*
% Overweight
4
2.5
15–19
Ideal
5
3
20–24
6
3.5
25–29
10%
7
4
30–34
20%
8
4.5
35–39
30%
9
5
40–45+
40%
9
5
40%
*Current body weight  (100  % BF)/0.8. Lean mass is 80% of ideal weight (assuming 20% BF).
BCS, body condition score; BF, body fat; BW, body weight.
7
2014 AAHA Weight Management Guidelines for Dogs and Cats
and well tolerated.40,41 Calculate the daily RER for ideal
BW in kg using one of the following two equations. Note
that the first equation can be used for patients of any
weight. The second equation is used for patients weighing
2–25 kg, but note that the second equation is not as
accurate as the first equation as it will overestimate the
caloric needs of patients weighing either  2 kg or
 25 kg.
RER in kcal/day = 70(ideal BW [kg])0.75
RER in kcal/day = 30(ideal BW [kg])70
Select a Diet
Select a diet based on the caloric restriction desired, the degree of
obesity, and the preferences of the patient and client. Inquire about
preferences regarding flavor and dry versus canned foods. Evaluate
and prepare a list of diet options that vary within those parameters
if the first or second choice does not meet with acceptance from
the client or pet. Determine availability and affordability concerns
that might influence diet selection.
Before starting a plan, make sure that everyone involved in
the pet’s care is interested and receptive, ensuring that the plan is
practical and feasible for the client’s abilities and lifestyle. Then
calculate the daily food dose and translate that dose into quantities of cans and/or cups/day. If possible, weigh dry food on a scale
because measuring with a cup may be imprecise, particularly with
the small amounts needed for cats and small dogs (calculate the
food dose using the kcal/kg obtained from either the pet food
label or the manufacturer).42 Incorporate a treat allowance of up to
10% of total calories into the daily caloric goal. Explore, address,
and realign client expectations if necessary.
Essential nutrients in pet foods are balanced according to
caloric content, so when portion size (and thus calories) is reduced,
so are the amounts of essential nutrients. A review of the process
for a comprehensive analysis of nutritional adequacy of a diet is
beyond the scope of these guidelines; however, evaluating a diet
for sufficient protein is an important step for weight loss plans.
Consider dietary protein on an energy basis (in g/1,000 kcal) to
Evaluate how food plays a role in the client
relationship with the pet, such as food used for
training, nurturing, or bonding in specific situations.
evaluate the impact of the proposed reduction of caloric intake on
National Research Council recommended allowances (Table 2).
For a quick rule of thumb to ensure that the diet contains adequate protein, select foods that provide cats with  5 g/kg BW
and dogs with  2.5 g/kg BW based on ideal BW (see Evaluating
Protein Sufficiency sidebar).43–45
A therapeutic food is defined as a pet food that was purposely formulated to help modulate either a disease or condition.
Therapeutic foods are only available either through a veterinary
office or with a prescription from a veterinarian. Using a therapeutic weight-loss diet is preferred over using reduced amounts of
over-the-counter (OTC) diets because therapeutic diets are more
likely to provide adequate nutrient intake when fed in calorically
restricted amounts.
Therapeutic weight loss diets are formulated to contain more
TABLE 2
Minimum Protein Requirements in Diets72
NRC recommended allowances for protein/kg of ideal BW per day
Minimum protein needed in diet to meet NRC recommended allowances
When fed at 80% of RER for ideal BW
When fed at 60% of RER for ideal BW
Cat
4.96 g protein/BW (kg)
0.67
89 g/1,000 kcal
104 g/1,000 kcal
Dog
3.28 g protein/BW (kg)0.75
60 g/1,000 kcal
79 g/1,000 kcal
BW, body weight; NRC, National Research Council; RER, resting energy requirement.
8
©istock.com/Laks-Art
2014 AAHA Weight Management Guidelines for Dogs and Cats
protein, vitamins, and minerals/calorie than OTC foods, ensuring
adequate nutrient intake during caloric restriction. High protein
may preserve muscle mass during weight loss and may improve
satiety.46,47 As the effects of aging on protein digestibility are not
well understood, senior pets may require closer monitoring of
protein intake (and MCS) during weight loss.48 Therapeutic foods
also may be lower in fat, higher in fiber, and/or higher in moisture
to decrease caloric density. That allows clients to feed a greater
volume of food with fewer calories.
The role of fiber in satiety for dogs and cats is controversial and
likely varies among pets.46,49–51 The crude fiber analysis, which is
required on a pet food label, accounts for only the insoluble fiber
fraction and none of the soluble fiber content and is an underestimate of the true fiber content of most pet foods. Diets containing
insoluble fiber purportedly have a lower caloric content by volume
and may promote satiety, leading to better diet plan adherence.46
Insoluble fiber may cause an increase in the volume and frequency
of bowel movements.52 Discuss that potential effect of fiber with
clients when selecting a diet.
Restricting the amount of OTC maintenance food that is fed,
especially diets with high caloric density, generally fails to provide
satiety for most pets, contributing to poor adherence and client
frustration. Restricting amounts of an OTC maintenance diet fed
could also lead to deficiency of one or more essential nutrients.53
The current median kcal/cup of therapeutic and OTC dry
foods marketed for weight management are 301 kcal/cup (dogs)
and 342 kcal/cup (cats).54 However, there is wide variation and
there are no nutritional or caloric criteria mandated for the terms
such as “less active,” “indoor,” “weight control,” “optimal weight,”
or “healthy weight.” Products labeled “less” or “reduced” calories
or fat have no restriction on calorie or fat content other than
being some amount lower than the company’s chosen comparison
product. Foods with labels stating “lite” or “light” must contain
less than a certain amount of calories/kg set by the Association
of American Feed Control Officials (AAFCO), although there
is no restriction on calories/cup or can.22 For specific definitions
and amounts that qualify as “light,” see the AAFCO 2013 Official
Publication.22 Due to the wide variability of products with such
labeling, achievement of weight loss requires careful evaluation of
those products on a case-by-case basis.
When advising clients about amounts to feed, it is best to
do so based on a caloric target, not just a variation on the label
range. Pet foods that show similar caloric content/cup or content/can may show entirely different recommendations about the
amount to feed. Compare the caloric density, not the label feeding
amounts, to determine caloric intake.
In some instances it may be appropriate to adjust volume alone
and not change to a therapeutic diet if the pet can lose weight
with modest caloric restriction and without feeding below the
label guidelines to provide calories for ideal weight. That process
will ensure the pet receives adequate nutrients. For example, that
approach may apply to either cats being transitioned to meals
from free feeding or to pets just slightly overweight and easily able
to increase activity.
There is little to no evidence showing that any nutritional
supplement aids in weight loss.55 There is one FDA-approved pharmaceuticala that is currently available for the management of obesity
in dogs. That medication was evaluated in a safety and efficacy study
up to 1 yr’s duration when used with a maintenance diet.56 As with
any medication, it may not be appropriate for every patient.
Evaluating Protein Sufficiency
Using RERs and BW67,68
Because labels do not show protein content in g per 1,000
kcal, the g of protein being fed can be calculated using the
“guaranteed analysis” and the following information:
Assume an overweight dog with 10 kg ideal body weight.
Assume your food label shows 21% crude protein and
contains 3,490 kcal/kg.
1.Calculate dog’s caloric needs at 80% resting
energy requirements (see text), use the
following equation:
80%(70  10 kg0.75) = 315 kcal/day
2.Calculate g of protein in the food using the
following equation:
(%crude protein/kcal/kg)  10,000 = g/1,000 kcal of food
21/3,490 kcal/kg  10,000 = 60 g/1,000 kcal
3.Determine dog’s daily protein requirement
using the following equation:
5 g/kg for cats and 2.5g/kg for dogs
2.5 g/kg  10 kg BW = 25 g protein/day
4.Determine whether the food provides
sufficient protein to meet canine pet’s needs
using the following equation:
315 kcal/day  60 g/1,000 kcal = 18.9 g/day
18 g  25 g
This food does not provide sufficient protein.
9
2014 AAHA Weight Management Guidelines for Dogs and Cats
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
Introducing physical activity in cats can be
challenging. Recommendations focus on
environmental enrichment to encourage
activity and modify behavior.
10
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
Monitoring and Maintenance
Effective follow-up and regular monitoring by the entire veterinary team are critical components of a successful weight loss
program. Consider some of the following points:
yy Train the veterinary team to provide consistent
information about diet and feeding for each life stage.
yy Implement multimodal client reminder systems (e.g.,
postcards, phone calls, emails).
yy Designate specific team members for client support and
follow-up encouragement.
yy Provide or recommend that clients participate in group
programs (e.g., dog walking groups, agility clubs).
Once a program has been initiated, contact the client after the
first week as many get discouraged with concerns such as food
refusal and begging behaviors that are best addressed early on.
Provide clinical support from team members via frequent phone
calls between weight checks. Identify and address obstacles and
client concerns, satisfaction, or frustrations with the program.
Follow up with the client either by telephone or an office visit
q 2 wk until the desired rate of weight loss is established. Monitor
the patient monthly until the ideal weight has been reached and
has stabilized on a long-term maintenance program.
Suggested Follow-Up Procedure
Consider some of the following suggestions when following up
with the patient and clients:
yy Ask open-ended questions to solicit client observations and
concerns. Provide positive reinforcement.
yy Record BW, MCS, and BCS. It may be useful to show
the client measurements of either girth or abdominal
circumference to emphasize losses.
yy Take a picture of the patient. Create a chart to monitor
and show progress.
©jmbruchez/Getty Images
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.
11
2014 AAHA Weight Management Guidelines for Dogs and Cats
yy Calculate the rate of weight loss using the calculation:
%weight loss/wk
= (amount of loss since last visit/weight at last visit
 100/number of wk since last weight measurement)
xx The desired rate of weight loss in dogs is 1–2%/wk, and
in cats is 0.5–2%/wk.
xx Modify the rate of weight loss in growing pets  1 yr of
age (see previous comments about feeding for growth).
Depending on patient age, the focus may be to slow
weight gain rather than to cause weight loss.
xx Anticipate a possible slower rate of weight loss in patients
with a comorbid condition (such as hyperadrenocorticism
or hypothyroidism) either until or unless the primary
disease is addressed.
yy If MCS decreases, confirm adequate protein intake and
evaluate the patient for either too-rapid weight loss or
a comorbid condition that intensifies catabolism (e.g.,
diabetes, renal disease, hyperthyroidism), and adjust intake
to reduce the rate of weight loss.
yy If the desired weight loss is achieved, congratulate the
client and identify the next target weight.
yy If weight loss is greater than the above-described desired
rates, increase calories by 10% and monitor response.
Reassess if Weight Loss Is Insufficient
If the desired weight loss is less than the above-described desired
rates, consider the following:
yy Evaluate either adherence or other influences that may
have tempered results and suggest alternatives.
yy If adherence is verified and there is no evidence of risk,
TABLE 4
Websites for Additional Information
Website
URL
Information on website
American Animal
Hospital Association
aahanet.org
aahanet.org/Library/Guidelines
Terms.aspx
Nutritional assessment guidelines; canine and feline life stage
guidelines; nutritional assessment tools.
American Association
of Feline Practitioners
catvets.com
Feline life stage guidelines; feline behavior guidelines; feline
environmental needs guidelines; environmental enrichment tips.
American Veterinary
Medical Association
ebusiness.avma.org/
EBusiness50/ProductCatalog/
ProductCategory.aspx?ID=132
Client brochures, including “Your Pet’s Healthy Weight.”
Association for Pet
Obesity Prevention
PetObesityPrevention.org
Weight loss tools, pet food information.
Association of American Feed
Control Officials (AAFCO)
General information about pet food label regulations; pet
petfood.aafco.org/
LabelingLabelingRequirements.aspx food regulations label review checklist, including specific term
petfood.aafco.org/Presentations.aspx definitions for weight management and calorie claims
(see part IX, pages 169–200).
Catalyst Council
catalystcouncil.org/resources/
health_welfare/
List of links and resources, including environmental enrichment
and exercise ideas for vets and cat owners.
Indoor Pet Initiative
Indoorpet.osu.edu
Indoor pet initiative to increase environmental enrichment.
Partnership for Healthy Pets
partnersforhealthypets.org/practice_
resources_overview.aspx
Practice resources and tools.
Pet Nutrition Alliance
petnutritionalliance.org/
About_Us.aspx
Comprehensive nonbranded site providing tools and nutrition
resources for health care professionals and clients.
Texas A&M University
vetmedicine.org/vetmednet/index.
php?pageid=5013
Weight reduction calculator.
World Small Animal
Veterinary Association
wsava.org/nutrition-toolkit
Nutrition toolkit; simple and extended diet history form template;
pet food selection handout, including how to select a pet food.
12
2014 AAHA Weight Management Guidelines for Dogs and Cats
reduce calories by 10–20% and/or change activity
recommendations and identify the next benchmark.
xx In the authors’ experience, to achieve weight loss, most
patients can tolerate caloric restriction as low as 60% of
RER of ideal BW without adverse clinical signs.64,65 Warn
clients that that approach will likely differ from feeding
instructions on the label.
xx More aggressive caloric restriction ( 60% RER)
increases the risk of nutritional deficiencies and
undesirable pet behavior that will test the client’s
commitment and adherence. Both commercial and
therapeutic diets may lack adequate levels of essential
nutrients at that level of caloric restriction. Cats may also
have increased risk of hepatic lipidosis.
xx Consult with or refer to a board-certified veterinary
nutritionist for clients with pets requiring  60% RER
to achieve weight loss.
yy Schedule the next weight check or telephone follow-up.
Maintain Weight Loss Once Goals Are Achieved
Once the pet has reached its ideal BW, careful monitoring is essential to avoid weight regain. Some pets may have a propensity to
quickly regain excess BW after a period of weight loss if healthy
lifestyle habits are not continued.
Selection of a diet for BW maintenance is based on the pet’s
metabolic needs and client preferences, but during maintenance
many pets still require relatively low caloric intake.40 When faced
with caloric restriction, some pets’ metabolism may reset at a
lower rate and, thus, they may require greater caloric restriction
than expected after the ideal BW has been achieved.66 Some pets
may plateau at an ideal BW and require no change in intake from
that used during the weight loss program for weight maintenance
going forward.
If the patient is still losing weight once the ideal BW is
achieved, increase caloric intake by 10% to change from weight
loss to weight maintenance. Monitor q 2 wk until stable BW is
achieved then monitor monthly to make sure ideal BW is being
maintained, making adjustments if necessary. It may take several
monthly recheck exams to determine appropriate maintenance
energy requirements.
Client Communication and Pet Behavior Modification
The process of managing and encouraging weight-loss programs
can be challenging. Weight loss is seldom continually linear, which
can frustrate pet owners and veterinary staff. Factors that affect
programs are both pet- and client-related. Some common areas
that challenge successful weight loss, and possible solutions, are
shown in Table 3. Internet resources for tools and further information are listed in Table 4.
Once the pet has reached its ideal BW, careful
monitoring is essential to avoid weight regain.
Conclusion
This article highlights the importance of weight management
and is meant to aid in the implementation of successful weight
management programs. The authors’ intent is also to stimulate
discussion about, and encourage further investigation into, weight
management for pets. The prevalence of overweight dogs and cats
is excessively high, and the authors would like these guidelines to
serve as a call to action for small animal practitioners everywhere
to give these patients the attention they merit.
There is a need for further research to develop more effective
strategies for achieving successful weight loss in dogs and cats.
Design of effective exercise programs is hampered due to lack of
information on calories expended during many forms of exercise.
It is the authors’ hope that future research will aid the practitioner
in the development of strategic exercise plans for dogs and cats.
Additionally, the authors feel strongly that the pet food industry must provide standardized and consumer-friendly nutrient
profile information and clearer feeding guides on pet food labels
to enable veterinary teams and consumers to make more informed
diet and feeding management choices for pets. The new AAFCO
requirement to show caloric content on pet food labels is not
scheduled to be fully implemented until 2015.
The recent designation of obesity as a disease by the American
Medical Association is compelling as it offers recognition of the
serious and complex nature of the condition, but it may have unintended consequences. Although beyond the scope and mission of
these guidelines, further discussion of that matter in veterinary
medicine is warranted.
A successful weight management program will greatly improve
the health of pets, reduce the potential for future health concerns,
increase the level of activity of pets, and ultimately will improve
the client/patient bond. 
a
©istock.com/amriphoto
Dirlotapide; Zoetis, Florham Park, NJ
13
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Tip Sheet
Calculating a Pet’s Caloric Intake for Weight Management
Calculate the Resting Energy Requirement (RER) using the pet’s estimated ideal weight, then feed a percentage of that amount.
Although there is no established standard reduction, feeding 80% of ideal-weight RER is effective and well tolerated.
Calculate the daily RER for ideal body weight in kilograms (BWkg) using one of the following equations:
a.RER in kcal/day = 70  (Ideal BWkg)0.75. This equation can be used for patients of any weight.
b.RER in kcal/day = 30  (Ideal BWkg) + 70. This formula is less accurate as the previous one. It will overestimate
large and underestimate small patients’ caloric needs. Use it only for patients weighing 2–25 kg (6–60 lb).
RER (in kcal) for Various Body Weights (in kg)*
Ideal body
weight
RER
Ideal body
weight
RER
Ideal body
weight
RER
Ideal body
weight
RER
Ideal body
weight
1
70
11
423
21
687
31
920
41
1,134
51
1,336
2
118
12
451
22
711
32
942
42
1,155
52
1,356
3
160
13
479
23
735
33
964
43
1,175
53
1,375
4
198
14
507
24
759
34
986
44
1,196
54
1,394
RER
Ideal body
weight
RER
5
234
15
534
25
783
35
1,007
45
1,216
55
1,414
6
268
16
560
26
806
36
1,029
46
1,236
56
1,433
7
301
17
586
27
829
37
1,050
47
1,257
57
1,452
8
333
18
612
28
852
38
1,071
48
1,277
58
1,471
9
364
19
637
29
875
39
1,092
49
1,296
59
1,490
10
394
20
662
30
897
40
1,113
50
1,316
60
1,509
*RER in kcal/day = 70  (ideal body weight in kg)0.75
RER, Resting Energy Requirement
15
Model Protocol
This form is available at the
AAHA Download Center.
aahanet.org/library/Weight_Management_Download_Center.aspx
Dogs and Cats
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16
Weight Management Algorithm
Take a full dietary history and perform a physical exam. That exam should
include a nutritional assessment with body condition score (BCS) and/
or muscle condition score (MCS). Explain what you are doing as you do it.
Record the nutritional assessment and BCS/MCS in the medical record.
Yes
Has the client been informed
about weight management?
No
Yes
Introduce the concepts of ideal
weight and weight management.
Discuss weight
management
and assess client’s
readiness to change.
Is the client ready to
proceed now?
Yes
No
Discuss and
determine
obstacles.
Describe the pet’s current
weight and BCS. Is the pet
at its ideal weight?
Yes
No
No
Is the pet on a weight
management plan?
Yes
Has current
weight
loss goal
been met?
Yes
Congratulate
and encourage
to keep up the
good work!
No
Ask questions to tailor the weight management
plan to the client’s and pet’s unique situation. Address
problems and pose possible solutions.
Create or revise a plan, including feeding amounts, diet type,
treats and exercise. Record the nutritional assessment and
dietary recommendation in the medical record at every visit.
Inform client of recommended next steps. Determine timing of weigh-ins
and subsequent evaluations. Make the appointments. Insert information into
reminder system. Print report/checklist for client.
Re-evaluate
and reweigh periodically.
Create next goal at
each weigh-in.
©istock.com/atwstudios
17
Model Task Checklist
Use Checklists to Ensure Consistency
Checklists help you deliver the same high-quality care to every patient. When clients are asking questions or you are focusing on handling
their pet, it’s easy to skip routine steps you’d normally remember. Use this tool to create checklists based on your practice’s protocol.
Designing a weight loss plan

Estimate the pet’s ideal weight using methods described in the 2014 AAHA Weight Management Guidelines for Dogs and Cats.

Ask the client about their pet’s current diet, including all food, chew toys, treats (including table scraps) and access to other pets’ food.

Assess and document the current caloric intake.

Evaluate the role of food in the relationship between client and pet.

Determine the daily caloric goal using methods described in the 2014 AAHA Weight Management Guidelines for Dogs and Cats.

Select a diet based on the caloric restriction desired, the degree of obesity and the preferences of the client and pet.

Determine the daily treat allowance, if applicable. For example, incorporate a treat allowance up to 10% of total calories into the
daily caloric goal. It can be challenging to learn the caloric content of various treats, and the calorie count changes frequently.
Call the manufacturer to get that information.

Evaluate the nutrient profile, particularly protein, in the diet as described in the 2014 AAHA Weight Management Guidelines for Dogs and Cats.

Modify diet type and/or amount as necessary.

Discuss with the client the amount of food and treats to give each day.

Discuss and decide on an exercise plan.

Enlist the support of all family members to enforce the pet’s weight loss plan.
Addressing bumps in the road

Ask open-ended questions to determine client’s perception of problems.

Show empathy and concern. Acknowledge that weight management can be difficult and you are there to help.

Propose strategies to address client concerns. To develop strategies, use the outline of possible problems and solutions in the 2014
AAHA Weight Management Guidelines for Dogs and Cats, and the “What Should I Do If ..?” client handout in this toolkit (page 21 and in
the AAHA Download Center. aahanet.org/library/Weight_Management_Download_Center.aspx).

Evaluate the current diet and treats, and determine whether modification is necessary.
18
©istock.com/busypix
Suggested follow-up procedure

Ask open-ended questions to encourage clients to share their observations and concerns. Provide positive reinforcement.

At each visit, record weight, muscle condition score (MCS) and body condition score (BCS). Instructions for scoring are included in
the 2010 AAHA Nutritional Assessment Guidelines for Dogs and Cats and in the AAHA Download Center.
aahanet.org/library/Weight_Management_Download_Center.aspx

Consider showing the client measurements of girth or abdominal circumference to emphasize losses.

Take a picture. Create a chart to monitor and show progress.

Calculate the rate of weight loss using the following formula:
The percent rate of weight loss per week = (loss since last visit/weight at last visit  100/number of weeks since last weight measurement)
The desired rate of weight loss is 1–2%/wk for dogs and 0.5–2%/wk for cats. For growing pets  1 year of age, adjust the plan. See
previous comments about feeding for growth (page 6). Depending on the pet’s age, the focus may be to slow weight gain instead
of causing weight loss.

Anticipate a possible slower rate of weight loss in patients with a comorbid condition, such as hyperadrenocorticism or
hypothyroidism, until or unless their primary disease is addressed.

If MCS decreases, confirm adequate protein intake and evaluate for either too-rapid weight loss or a comorbid condition that
intensifies catabolism (e.g., diabetes, renal disease, hyperthyroidism). Adjust intake to reduce the rate of weight loss. If the desired
weight loss is achieved, congratulate the client and identify the next target weight.

If weight loss is greater than the desired rate, increase calories by 10% and monitor weight response.

Modify diet type and/or amount as necessary.

Discuss with the client the amount of food and treats to give each day.

Discuss and decide on an exercise plan.

Enlist the support of all family members to enforce the pet’s weight loss plan.
If weight loss is less than the desired rate

Evaluate compliance or other influences that may have tempered results and suggest alternatives.

If compliance is verified and there is no evidence of risk, reduce calories by 10–20% [to a minimum of 60% of Resting Energy
Requirement (RER) for ideal weight] and/or change activity recommendations and identify the next benchmark.

Consult with or refer to a board-certified veterinary nutritionist for clients with pets requiring  60% RER to achieve weight loss.

Schedule the next weigh-in or telephone follow-up.
19
Staff Roles and Responsibilities
Doctors
Discuss the guidelines and toolkit at a doctor’s meeting. Write
your practice’s protocol. Decide responsibilities for completing
specific tasks and assign to doctors and technicians. With technicians, choose the dietary history/nutritional assessment form to be
used (see the sample in the AAHA Download Center. aahanet.org/
library/Weight_Management_Download_Center.aspx).
Practice manager
Meet with doctors and technicians to discuss how the guidelines
and the toolkit will be used. Save the completed protocol, and
schedule periodic reviews/updates of it. Maintain an adequate
supply of materials required to implement the guidelines in
appropriate places, such as exam rooms and the reception desk.
Plan team meetings for training and motivation. Track scheduling
and follow up on reminders and appointments.
Technicians
With doctors, determine what tasks and procedures will be performed by technicians and what tasks and procedures will be
performed by doctors. With the client, review the pet’s diet and
medical history. With the client, review the weight management
program and the services that will be provided. Show the client
relevant educational materials. Perform between-exam weigh-ins
as designated by the doctors. Follow up with the client via appropriate channels (e.g., email, phone) to check the pet’s status.
Client service representatives
Answer client questions, or let clients know who will be able
to do so. Give clients relevant printed information at checkout.
Review procedures that were performed, explaining the value
of regular weight monitoring. At checkout, schedule follow-up
appointments and the next weigh-in appointment. Emphasize
that maintaining the pet’s ideal weight promotes the pet’s quality
of life and longevity. Send reminders at appropriate times using
the client’s preferred method (e.g., text, email, telephone, mail).
All practice team members
In a team meeting, discuss the 2014 AAHA Weight Management
Guidelines for Dogs and Cats. Discuss how you will implement the guidelines and use the tools in this toolkit and the
AAHA Download Center (available at: aahanet.org/library/
Weight_Management_Download_Center.aspx). Clarify each team
member’s role. Discuss ways to educate and motivate clients to
participate as your partner in their pet’s care and to accept your recommendations, and follow the guidelines with your own pets.
20
©Alloy Photography/Veer
Client Handouts
These home care instructions are available at the AAHA Download Center.
aahanet.org/library/Weight_Management_Download_Center.aspx
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21
Talking Points for Partnering with Clients
Discussing weight
1.Open the conversation.
xx Can we talk about Bella’s weight?
xx What are your thoughts about Bella’s weight?
2.Build awareness of health issues without overloading the
listener with details about disease.
xx May I show you a diagram that illustrates the ideal
weight for Bella?
xx Your pet falls into this BCS (show them on the chart).
xx There are several health issues that can arise in pets
because of excess weight. For example, arthritis can be
aggravated or diabetes can develop.
3.Assess client’s readiness to change.
xx Would you be willing to discuss a weight management
program for Bella?
xx What are your thoughts about making changes to
improve Bella’s weight?
xx We can help you devise a weight management plan
that is practical for you and your family when you are
interested and ready.
4.Provide support and encouragement
xx We know you love Bella very much.
xx Weight loss programs can present some challenges, and
we are here to help you through those.
Assessing readiness to change
Is your client ready to take on a weight loss program for his or her
pet? Enhance the chances for success with these tips:
yy Establish trust by using active listening skills and showing
concern for the client and his or her pet.
yy Use a collaborative approach to determine the client’s state
of awareness about his or her pet’s weight and its health
consequences.
yy Ask questions to determine whether the client needs time
to consider the information or is ready to take action to
begin a weight loss program.
yy Give clients time to think, but be aware that “thinking
about it” may signal inability or unwillingness to follow
your recommendation.
yy Ask open-ended questions to elicit clients’ concerns about
weight management.
yy Schedule a subsequent visit to discuss weight management,
encouraging other family members to attend.
Negotiating a mutual plan of action for
changing feeding practices*
yy Obtain the client’s beliefs and understanding about how
their pet should be fed.
yy Obtain the client’s viewpoint regarding the need to
change feeding practices (e.g., perceived benefits, barriers,
motivation to changing practices).
yy Take into consideration the client’s beliefs, cultural
background, lifestyle and abilities when formulating your
plan for dietary modification.
yy Elicit the client’s reactions and concerns about the
proposed dietary modifications.
Managing the process
yy Prepare the client for the process.
yy Explain what to expect for weight loss over time.
yy Discuss hurdles that may arise and your partnership in
tackling those hurdles.
yy Provide client resources, such as an exercise or calorie
tracking diary.
yy Provide empathy and positive reinforcement.
yy Explore client’s feelings/beliefs about the program.
yy Give permission to fumble/fail with no judgments attached.
yy Explain your willingness to change benchmarks if needed,
and that weight management programs will be adapted to
the client’s and pet’s individual needs (i.e., there is no “onesize-fits-all” approach).
Source: Churchill J. Increase the success of weight loss programs by creating an environment for change. Compend Cont Educ Vet 2010;32(12): E1–4. Used with permission.
*Adapted from the Calgary-Cambridge Guides; Kurtz S, Silverman J, Draper J. Teaching and learning communication skills in medicine. 2nd ed. Oxford (UK): Radcliffe Publishing ; 2005; and Silverman J, Kurtz S, Draper J.
Skills for communicating with clients. 2nd ed. Oxford (UK): Radcliffe Publishing; 2005. Used with permission.
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©istock.com/SPEEDY
Weight Management Resources
From AAHA Press (press.aahanet.org)
Dogs Lose Lbs! You Win!
Slim Your Dog and Shape Up Yourself
A great client handout. Buy this inexpensive, motivating
booklet in bulk to encourage clients to focus on their dogs’
eating and exercise habits. The booklet helps clients set
small, achievable goals with charts to track their progress.
Available at: bit.ly/16MeZOW
Your Pet’s Diet & Exercise Plan
Words fade fast. This brochure is a lasting reminder of key
messages about pet obesity, diet, treats and exercise. It
includes room to write the pet’s diet/exercise plan.
Available at: bit.ly/174OLKT
From the PNA
AAHA Download Center
Helping Pets Live Healthier, Thinner Lives:
AAHA Nutritional Assessment Guidelines
2014 AAHA Weight Management Guidelines for Dogs and Cats
This is an article by the Food and Drug Administration’s
Center for Veterinary Medicine. It discusses pet nutrition and
the AAHA Nutritional Assessment Guidelines for Dogs and Cats.
Available at: bit.ly/18s52tL
2014 AAHA Weight Management Guidelines for Dogs and Cats
Implementation Toolkit
Pet Owner Resources on Weight Management
and Obesity
Download the whole toolkit, or just the tools you need:
This collection of links from many sources includes, among
other resources, the following information:
aahanet.org/library/Weight_Management_Download_Center.aspx
2010 AAHA Nutritional Assessment Guidelines for Dogs and Cats
•• A model protocol. Fill in the form or distribute it for doctors to
review before meeting to discuss your practice’s protocol
•• A training tracker. This Excel spreadsheet includes two
worksheets: a sample training tracker and a blank for each
staff member.
•• A weight management algorithm
•• Model task checklists to customize for your practice
•• A nutritional screening form (simple version)
•• An extended nutritional assessment form
•• An illustrated guide to the MCS
•• An illustrated guide to the BCS
•• The tip sheet, “Calculating a Pet’s Caloric Intake
for Weight Management”
•• The tip sheet, “Deciphering the Pet Food Label”
•• The client handout, “Fit and Healthy for Life”
•• The client handout, “Looking Good! Staying Fit!”
•• The client handout, “What Should I Do If…?”
•• Tabletop poster: Dog obesity
•• Tabletop poster: Dog obesity (special version for AAHA
accredited members only)
•• Tabletop poster: Cat obesity
•• Tabletop poster: Cat obesity (special version for AAHA
accredited members only)
••“Weight Translator” tool
••Pet Nutrition in People Terms: Weight Gain
••BCS and MCS tools
••Article, “How Can I Tell if My Pet Is Overweight?”
••Client information sheets on weight management
This resource is available at: bit.ly/16CCUiO.
Veterinary Resources on Weight Management
and Obesity
This collection of links from many sources includes, among
many other resources, the following information:
••BCS and MSC tools
••Diet history and nutritional assessment forms
••Individualized feeding plan app/software
••Pet food label checklist for the exam room
••Food and treat list for the exam room
••Using “Healthy Weight Protocol” in the exam room
This resource is available at: bit.ly/18sBqub.
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About AAHA—The American Animal Hospital Association is an international organization of nearly 6,000 veterinary
care teams comprising more than 48,000 veterinary professionals committed to excellence in companion animal care.
Established in 1933, AAHA is recognized for its leadership in the profession, its high standards for pet health care and
most important, its accreditation of companion animal practices. For more information about AAHA, visit aahanet.org.
About the Pet Nutrition Alliance—When the American Animal Hospital Association (AAHA) made
the decision to develop the AAHA Nutritional Assessment Guidelines for Dogs and Cats, AAHA also made
the commitment to support the development of educational resources to increase compliance with all
AAHA guidelines’ recommendations. The World Small Animal Veterinary Association (WSAVA) used the
AAHA guidelines to develop the WSAVA Global Nutritional Assessment Guidelines. WSAVA has committed to
developing tools to support this initiative globally. To promote the importance of nutrition in the health of pets worldwide, the
following organizations have been working together on what has now become known as the Pet Nutrition Alliance (PNA):
American Animal Hospital Association
American Veterinary Medical Association
American Academy of Veterinary Nutrition
American College of Veterinary Nutrition
American Society of Veterinary Medical Association Executives
Canadian Veterinary Medical Association
National Association of Veterinary Technicians in America
World Small Animal Veterinary Association
This implementation toolkit is
sponsored by a generous educational
grant from Hill’s Pet Nutrition and Zoetis.
This implementation toolkit was developed by
the American Animal Hospital Association (AAHA) to
provide information for practitioners regarding weight
management for canines and felines. The information contained
in this toolkit should neither be construed as dictating an exclusive protocol,
course of treatment or procedure, nor should it be interpreted as an AAHA standard of care.
©2014 American Animal Hospital Association (aahanet.org). All rights reserved. Front cover photo: ©istock.com/akrp, ©istock.com/GlobalP. Back cover photo: ©istock.com/yykkaa