Small Animal Clinical Nutrition 5th

1
Chapter
Small Animal
Clinical Nutrition:
An Iterative Process
Craig D. Thatcher
Michael S. Hand
Rebecca L. Remillard
Things should be made as simple as possible, but not simpler.

Albert Einstein
CLINICAL IMPORTANCE
The public has become increasingly more aware of the importance of nutrition to health during the past four decades as a
result of the growing recognition that food is associated with
disease processes such as coronary artery disease, hypertension,
obesity, diabetes mellitus and cancer. Healthy People 2010 is a
comprehensive set of disease prevention and health promotion
objectives for the United States. Healthy People 2010 uses 10
leading health indicators that reflect the major health concerns
in the nation at the beginning of the 21st century. These indicators were selected based on their importance as public health
issues and their ability to motivate action and provide data to
measure progress against specific goals. One of the focus areas
is nutrition, especially overweight/obesity conditions (Healthy
People 2010).
The discipline of veterinary nutrition and its relationship to
the practice of veterinary medicine have benefited from these
changes. Food animal veterinarians have long recognized that
no aspect of the production enterprise has more impact on
health and production than nutrition; many health problems
are associated with inadequate feeding programs. Food animal
veterinarians recognize that optimizing feeding programs
improves food animal health and productivity and, as a result,
the economic status of producers. Food animal veterinarians
who provide their clients with high-quality production medicine programs become unbiased nutritional consultants.
Similarly, small animal practitioners must improve their

nutritional counseling skills because they cannot truly meet
their patients health needs without optimizing nutrition.
Small animal veterinarians can improve the quality of medicine delivered to their patients by knowledgeably and systematically addressing the nutritional aspects of each case, whether
the goal is treating or preventing disease. Veterinarians must
emphasize health maintenance and wellness strategies for
companion animals to provide the most beneficial service.
Total disease prevention requires lifelong dedication to proper
nutrition, immunizations, dental care and parasite control programs. Nutritional factors are a cornerstone in maximizing
health, performance, longevity and disease prevention.
Nutritional counseling and intervention, however, are beneficial only if done properly.
Veterinarians and their health care teams have considerable
influence on the foods clients feed their pets. A study conducted by Veterinary Economics in 1990 found that 87% of veterinarians felt that offering nutritional services improved their practices (Gants, 1990). Ninety-four percent of these veterinarians
said that their clients were somewhat or very receptive to nutrition-related information. A 1995 study conducted by the
American Animal Hospital Association found that 54% of pet
owners interviewed sought veterinary advice on pet foods at
least once and 43% had received a recommendation from their
veterinarian on which manufacturers pet food to feed their puppies or kittens. Seventy percent of the latter group fed the brand
of food recommended by their veterinarian (AAHA, 1995).
Small Animal Clinical Nutrition
The word recommend means to counsel or advise (American

Heritage Dictionary). The implication is that the advice proceeds from actual knowledge of the subject. Veterinarians
should know how food needs vary with each lifestage, with
mental, physical and environmental stresses and with diseases.
Causes and effects of dietary imbalances should be considered
so that the resulting disorders can be prevented or diagnosed
and treated. Veterinarians should also be familiar with the various pet foods available to help clients choose the most appropriate ones. Veterinarians also need to understand the benefits
and shortcomings of various feeding methods. After a feeding
plan has been instituted, veterinarians need the skills to monitor the program to assess and reassess outcomes and to modify
the feeding plan when necessary. The primary goal of this
chapter is to provide practicing veterinarians, veterinary technicians and students with the basic problem-solving processes
needed to successfully manage the nutrition of companion animal patients.
The Two-Step Iterative Process

of Clinical Nutrition
A brief review of instructional systems design (ISD) is in order
to better understand iterative (repetitive) processes. ISD
emerged after World War II as a set of recognized standard
procedures used to develop well-structured materials in
response to the need for more efficient training techniques
(Moore and Kearsley, 1996). ISD embodies various perspectives on learning, teaching, systems theory, behavioral psychology, communications and information theory. The ISD model
breaks instruction into a series of phases or steps with defined
procedures; a defined service or product must be delivered at
each step. Steps include: 1) design, 2) development, 3) implementation, 4) evaluation and 5) analysis. Then, the process
repeats itself as a continuous loop and may involve many cycles.

The American College of Veterinary Nutrition (ACVN) has
recommended that nutrition problem solving include assessment of the patient, the food and the feeding method (Bauer et
al, 1995).
Figure 1-1 depicts the iterative process used in this book.
The first step is patient assessment, which allows the determination of the patients key nutritional factors and their levels
(the concept of key nutritional factors is described below).
Determination of the key nutritional factors is the basis for the
second step: the feeding plan. The feeding plan includes recommendations for food and feeding methods. If assessment of the
current food and feeding methods indicates that they are
appropriate, the current feeding plan can remain in place.
However, if the assessment indicates otherwise, a new feeding
plan should be formulated and implemented.
After a suitable period of time (the length of which depends
on the patients condition), the two-step process is repeated to
determine the appropriateness or effectiveness of the new feeding plan. Thus, the patient is reassessed and, if necessary, a new
feeding plan is developed and implemented. This is the iterative or repetitive part of the process. Any number of iterations
of the two-step process can occur, depending on the needs of
each patient. A critically ill patient may need to be reassessed
every few hours, whereas a normal adult dog or cat may be
reassessed annually. The subsequent reassessment of the patient
at each cycle is also referred to as monitoring. This information
is discussed under the heading of reassessment in the chapters
that deal with patient assessment and feeding plans.
PATIENT ASSESSMENT
The goal of patient assessment is to establish a dogs or cats key
nutritional factors and their target levels in light of its physiologic or disease condition. The patients key nutritional factors
are the benchmark for assessing the animals food and selecting
a food. Assessment of dogs and cats to determine their key
nutritional factor status should be a structured process that
includes: 1) review of the history and medical record, 2) physical examination and 3) laboratory tests and other diagnostic
procedures (Remillard and Thatcher, 1989). These first three
steps determine the patients physiologic state and medical
diagnosis and are the basis for the fourth step, which is the
determination of the key nutritional factors and the estimation
of their target levels.
Obtain an Accurate History and

Review the Medical Record
Figure 1-1. The two-step process of veterinary clinical nutrition.
Obtaining the animals history and reviewing the medical

record help determine the nutritional status of the patient. The
signalment is part of the history and defines the patients physiologic state and includes: 1) species, 2) breed, 3) age, 4) gender,
5) reproductive status, 6) activity level and 7) environment.
A complete history should also include questions about the
pets weight and therapies (medical, surgical, etc.) that may
affect appetite, nutrient metabolism or both. An accurate
description of the current feeding plan, including the animals
food, eating and drinking habits and feeding methods should
be obtained from the client. Intakes of treats and nutritional
supplements should be recorded.
Review of the medical record provides objective historical
information and documents the pets previous health status,
health maintenance procedures that were performed and medications that were prescribed. Veterinarians should evaluate this
information to determine if any of these factors are related to
the animals current nutritional status. This review permits early
nutritional intervention in the treatment of established malnutrition (under- or overnutrition) and in the prevention of malnutrition in individuals at risk (Box 1-1).
A patients food is usually changed because of altered
requirements or alterations in nutrient intake, digestion,
absorption, metabolism, excretion or a combination of these
factors. Knowledge of normal nutritional physiology and of diseases and their nutritional pathophysiology is important to
identify patients at risk for malnutrition. The history and medical record are tools to help identify these risks.
Conduct a Physical Examination

A thorough physical examination can help define an animals
nutritional status and identify diseases that may have a nutritional component. Physical findings should be recorded in the
patients medical record. Veterinarians should examine each
body system for problems that are responsive to nutritional
intervention. An animals body condition will likely reflect
abnormalities of major organ systems.
Body condition can be subjectively assessed by a process
called body condition scoring. In general, this process assesses a
patients fat stores and, to a lesser extent, muscle mass. Fat cover
is evaluated over the ribs, down the topline, around the tailbase
and ventrally along the abdomen. Body condition score (BCS)
descriptors have been developed with respect to the species
(dogs and cats) and age of the patient (Figures 1-2 and 1-3).
Score descriptors vary due to the structural differences
Box 1-1. Malnutrition Includes Excesses.

Malnutrition is defined as any disorder of nutrition with inadequate or unbalanced nutrition. Many veterinarians and animal owners think only of nutritional deficiencies when they
hear the term malnutrition. Muscle wasting and a distended
abdomen in a starving third-world child or a heavily parasitized puppy is often our first mental image of malnutrition.
In first-world societies, however, malnutrition is usually due to
overnutrition or excessive intake of nutrients. Obesity due to
consumption of excessive levels of fat and calories is a common example of malnutrition in people and their pets. Another
example of malnutrition due to unbalanced nutrition is developmental orthopedic disease seen in rapidly growing largeand giant-breed puppies as a result of excessive calcium and
energy intake. Malnutrition due to either nutrient deficiencies
or excesses can be harmful to dogs and cats.
between species and between young and adult pets. The scores
range from 1 to 5 with 1 being very thin and 5 being grossly
obese. A body condition score of 3/5 is generally referred to as
being ideal. An ideal body condition, however, depends on
the dogs or cats lifestage, lifestyle and intended use. For example, a BCS of 2/5 to 2.5/5 may be desirable for a racing greyhound, whereas a BCS of 3.5/5 might be better for a pregnant
queen at the end of its first trimester to help support the
upcoming lactation. A BCS of 2.5/5 to 3/5 is probably ideal
for most mature dogs and cats for optimal health and resultant
longevity. Thus, overall, an ideal BCS is a range of numbers
rather than simply a 3/5.
Body condition scoring reasonably estimates an animals
body composition. Studies assessing scorer repeatability and
variations between scorers have found agreement between 80
to 90% of the measurements (LaFlamme et al, 1994; Graham
et al, 1982; Croxton and Stollard, 1976; Burkholder, 1994).
Research with cats found a correlation of 0.9 or higher
between BCS and body composition predicted from morphometry (LaFlamme, 1993). Veterinarians should routinely
assign BCSs, obtain body weights and record both in the medical record.
The patients body weight can be compared with breed
standards (Appendix 14) or with the animals previous body
weight from the medical record. The patients pre-illness body
weight or usual body weight during health can serve as a standard for determining the effect of illness on body weight. A history of rapid weight loss and a reduced BCS may indicate a
catabolic condition with a marked loss of lean tissue, dehydration or both. A history of progressive weight gain and an
increased BCS may indicate an anabolic condition with an
excessive accumulation of fat, water or both.
Conduct Necessary Laboratory Tests and

Other Diagnostics
No single laboratory test or other diagnostic procedure can
accurately assess a patients nutritional status. Routine complete
blood counts, urinalyses and biochemistry profiles, however, can
provide insight into the presence of metabolic disorders and
other diseases. Albumin concentration, lymphocyte count,
packed cell volume and serum total protein values may serve as
general indicators of nutritional status. Other chapters in this
textbook will discuss specific laboratory tests and other diagnostic procedures that may help assess healthy and sick patients.
Serum protein concentrations in people provide an estimate
of long- and short-term changes in nutritional status and correlate with morbidity and mortality (Giner et al, 1996). For
example, low serum albumin concentrations may indicate protein depletion due to chronic undernutrition or protein loss.
Shorter half-life serum protein concentrations such as prealbumin, transferrin, retinol-binding protein and fibronectin are
used in human medicine to assess short-term changes in nutritional status. However, these tests have not been routinely
available in veterinary medicine. Although not used widely,
serum creatine kinase concentrations are elevated in anorectic
cats and decline after 48 hours of nutritional support. Serum
BCS 1. Very thin

The ribs are easily palpable with no fat cover. The tailbase has a prominent raised bony structure with no tissue between the skin and bone. The
bony prominences are easily felt with no overlying fat. Dogs over six
months of age have a severe abdominal tuck when viewed from the side
and an accentuated hourglass shape when viewed from above.
BCS 2. Underweight
The ribs are easily palpable with minimal fat cover. The tailbase has a
raised bony structure with little tissue between the skin and bone. The
bony prominences are easily felt with minimal overlying fat. Dogs over six
months of age have an abdominal tuck when viewed from the side and a
marked hourglass shape when viewed from above.
BCS 3. Ideal
The ribs are palpable with a slight fat cover. The tailbase has a smooth
contour or some thickening. The bony structures are palpable under a thin
layer of fat between the skin and bone. The bony prominences are easily
felt under minimal amounts of overlying fat. Dogs over six months of age
have a slight abdominal tuck when viewed from the side and a well-proportioned lumbar waist when viewed from above.
BCS 4. Overweight
The ribs are difficult to feel with moderate fat cover. The tailbase has some
thickening with moderate amounts of tissue between the skin and bone. The
bony structures can still be palpated. The bony prominences are covered by
a moderate layer of fat. Dogs over six months of age have little or no
abdominal tuck or waist when viewed from the side. The back is slightly
broadened when viewed from above.
BCS 5. Obese
The ribs are very difficult to feel under a thick fat cover. The tailbase
appears thickened and is difficult to feel under a prominent layer of fat. The
bony prominences are covered by a moderate to thick layer of fat. Dogs
over six months of age have a pendulous ventral bulge and no waist when
viewed from the side due to extensive fat deposits. The back is markedly
broadened when viewed from above. A trough may form when epaxial
areas bulge dorsally.
Figure 1-2. Body condition score (BCS) descriptors for dogs in a five-point system.
BCS 1. Very thin

The ribs are easily palpable with no fat cover. The bony prominences are
easily felt with no overlying fat. Cats over six months of age have a severe
abdominal tuck when viewed from the side and an accentuated hourglass
shape when viewed from above.
BCS 2. Underweight
The ribs are easily palpable with minimal fat cover. The bony prominences
are easily felt with minimal overlying fat. Cats over six months of age have
an abdominal tuck when viewed from the side and a marked hourglass
shape when viewed from above.
BCS 3. Ideal
The ribs are palpable with a slight fat cover. The bony prominences are
easily felt under a slight amount of overlying fat. Cats over six months of
age have an abdominal tuck when viewed from the side and a well-proportioned lumbar waist when viewed from above.
BCS 4. Overweight
The ribs are difficult to feel with moderate fat cover. The bony structures
can still be palpated. The bony prominences are covered by a moderate
layer of fat. Cats over six months of age have little or no abdominal tuck or
waist when viewed from the side. The back is slightly broadened when
viewed from above. A moderate abdominal fat pad is present.
BCS 5. Obese
The ribs are very difficult to feel under a thick fat cover. The bony prominences are covered by a moderate to thick layer of fat. Cats over six months
of age have a pendulous ventral bulge and no waist when viewed from the
side due to extensive fat deposits. The back is markedly broadened when
viewed from above. A marked abdominal fat pad is present. Fat deposits
may be found on the limbs and face.
Figure 1-3. Body condition score (BCS) descriptors for cats in a five-point system.
creatine kinase concentrations may become a useful marker for

assessing and monitoring nutritional status in animals
(Fascetti et al, 1997).
Results of a single measurement or test must be interpreted
cautiously, because over- or under-hydration can alter concentrations of these proteins. Diagnostics such as radiography and
ultrasonography, including echocardiography, may be indicated
to further characterize the health status of patients. Results of
laboratory and diagnostic tests should always be viewed in the
context of findings from the history, physical examination and
the patients medical record.
Determine the Key Nutritional Factors and

Their Target Levels
The concept of key nutritional factors is fundamental to the
practical application of clinical nutrition used in this text.
However, to better understand the basis for this concept, a brief
review of nutrient requirements vs. nutrient allowances precedes the description of key nutritional factors.
Researchers traditionally have used normal dogs and cats to
determine nutrient requirements. In the United States, the primary sources for minimum nutrient requirements of healthy
dogs and cats are the National Research Council (NRC)
Nutrient Requirement bulletins published in 1985 and 1986,
respectively and recently updated as a combined edition (NRC,
1985; NRC, 1986; NRC, 2006). The requirements published in
1985 and 1986 were determined by feeding dogs and cats purified diets rather than commercially available foods. These NRC
values, therefore, were minimum nutrient requirements that
had to be extrapolated to the types of foods normally fed to
dogs and cats. In 1993 and 1994, the Association of American
Feed Control Officials (AAFCO) published recommended
nutrient profiles for dog and cat foods, respectively (Nutrient
Profiles for Dog Foods, 1993; Nutrient Profiles for Cat Foods,
1994). These nutrient profiles have been republished yearly and
are the official source for nutrient profiles for commercial dog
and cat foods in the United States.
The AAFCO nutrient profiles include safety factors similar
to those in the recommended dietary allowances (RDAs) that
have been established for people (NRC, 1989). These safety
factors compensate for changes in a foods nutrient availability
due to ingredient and processing variables and for individual
differences in nutrient requirements within dog and cat populations. Because of these safety factors, the term allowance is
better suited to describe AAFCO values than requirements.
AAFCO values are adequate to meet the known nutrient
needs of almost all healthy dogs and cats and are a better
source of feeding recommendations for most dogs and cats
than are minimum requirements. The earlier NRC bulletins
published for dogs and cats in 1974 and 1978, respectively, also
included safety factors and therefore were actually
allowances. Besides recommendations for lower limits,
AAFCO prescribes upper limits for certain nutrients with the
obvious implication that some nutrient excesses can be harmful. As with RDAs for people, AAFCO allowances for pet
food nutrient profiles are not necessarily optimal.
Instead of separate dog and cat editions, the recently updated NRC includes information about both species. It provides
nutrient requirements in three formats: minimum requirement,
adequate intake and recommended allowance (2006).
Minimum requirement is defined as the minimal concentration
or amount of a maximally available nutrient that will support a
defined physiologic state. Adequate intake is defined as the
concentration or amount of a nutrient demonstrated to support
a defined physiologic state when no minimum requirement has
been demonstrated. Recommended allowance is defined as the
concentration or amount of a nutrient in a diet formulated to
support a given physiologic state. The recommended allowance
is based on the minimum requirement with consideration for
the normal variation in bioavailability of the nutrient in typicalquality feed ingredients. If no minimum requirement is available, the recommended allowance is based on adequate intake.
Like the old editions, the more recent NRC edition also
includes safe upper limit levels for a nutrient when data are
available (NRC, 2006).
Neither NRC nor AAFCO has established nutrient profiles
for geriatric dogs and cats and those with specific disease
processes.
Key Nutritional Factors

Key nutritional factors encompass nutrients of concern and
other food characteristics. The concept of nutrients of concern
greatly simplifies the approach to clinical nutrition because
most commercial pet foods sold in the United States provide at
least AAFCO allowances of all nutrients. Thus, if a commercial food is fed, veterinarians and their health care teams need
only to understand and focus on delivering the target levels for
a few nutrients (nutrients of concern) rather than the 40 plus
nutrients currently recognized for cats and dogs (NRC, 2006 ).
Nutrients of concern encompass nutritional risk factors for
disease treatment and prevention as well as nutrients that are
key to optimizing normal physiologic processes such as
growth, gestation, lactation and physical work. The following
elements must be considered in determining key nutritional
factors and their target levels: 1) the patients lifestage and
physiologic state, 2) environmental conditions such as temperature, housing and pet-to-pet competition, 3) the nature of any
disease or injury, 4) the known nutrient losses through skin,
urine and gastrointestinal tract, 5) the interactions of medications and nutrients, if applicable, 6) the known capacity of the
body to store certain nutrients and 7) the interrelationships of
various nutrients.
Besides requiring specific levels of certain nutrients, some
patients have other food-related needs. These needs might
include management of acute or chronic systemic acid-base
balance, maintenance of a specific urinary pH range, certain
kibble texture, a specific range of digestibility or osmolality,
avoidance of certain protein sources and presence of specific
ingredients. Some nutrients and ingredients that are added to
foods provide other non-nutritive functions that can be
important to health and performance. Thus, specific food
characteristics or factors other than the nutrient content may
be important to consider. Information about such food characteristics should be available from product manufacturers.
Pet food labels contain addresses and toll-free phone numbers
of the manufacturer.
Chapters 12 through 24 determine and list key nutritional
factors and their target levels for healthy dogs and cats. The key
nutritional factors and their target levels for dogs and cats with
specific disease complexes can be found in Chapters 25 through
68. For convenience, these chapters also contain levels of key
nutritional factors in commercial foods typically marketed for
use in patients with various medical conditions. Regardless of
which nutrients are considered as key nutritional factors, the
reader should understand the various ways nutrient needs are
expressed. Box 1-2 describes the methods and units for expressing an animals nutrient needs.
In summary, the primary goal of patient assessment is to
establish the patients key nutritional factor needs. The key
nutritional factors are the benchmark for assessing the adequacy of a patients food. Additionally, the results of patient assessment are the basis for determining an appropriate feeding
method.
FEEDING PLAN
The feeding plan can be developed after the key nutritional factor needs have been determined. The feeding plan includes
what food or foods to feed and which feeding methods to use.
Thus, the first step is to assess the current food and to select the
best food to feed.
Assess and Select the Food

The primary components of food assessment should include: 1)
evaluation of the current foods key nutritional factor content
relative to the patients needs (determined during Patient
Assessment, above) and 2) determination whether or not feeding tests or clinical trials were conducted.
Determine the Foods Key Nutritional Factor Content

The key nutritional factors and their levels for most of the commonly used commercial foods are listed in the food tables in the
individual chapters. In most instances, these profiles will provide the necessary information. If the key nutritional factor
information of the food in question is not listed in the food
tables, the manufacturer should be contacted for that information. Pet food labels contain addresses and toll-free phone
numbers of the manufacturer.
Although much less convenient, there are other ways to
determine most of a foods key nutritional factor content.
Many, if not most, key nutritional factors are nutrients. Box 13 describes various ways to determine the nutrient content of a
food. Box 1-2 describes methods and units used in expressing
the nutrient content of food.
Key Nutritional Factor Comparison

Comparing a foods key nutritional factor content with the
patients needs will help identify any significant imbalances in
the food being fed. If the patients current food is adequate (key
nutritional factors in balance with the patients needs) then the
food currently being fed can continue to be fed. However, if
important excesses or deficiencies exist, the patients current
food must be balanced.
There are numerous approaches to balancing foods. Some
are rather extensive (Boxes 1-4 and 1-5). This section will
review the most practical methods including: 1) food replacement and 2) simple mathematical ration balancing (Pearson
square). Alternatively, veterinarians can contact a veterinary
nutritionist who accepts referrals. Both the ACVN and the
European College of Veterinary Nutrition (ECVN) have
diplomates who do referral work. Contact the executive director of the ACVN to obtain a list of diplomates who do nutrition referral work. Contact information for the executive director can be found in the AVMA Directory or online at
www.ACVN.org.
When comparing a foods key nutritional factor nutrient
content with a patients needs, methods of expressing nutrient
content of the food and nutrient requirements of the animal
must be compatible (same units). In this textbook, compatible
units are used in the food tables for comparing the foods key
nutritional factor content and the patients target values. See
Box 1-2 for more details about how food content and animal
needs are expressed.
Food Replacement
If food assessment indicates that an animals key nutritional
factor requirements are not being met, the most practical way
to balance a food is to simply select a different food (i.e., one
that does a better job of meeting the patients requirements).
The most likely application of this method occurs when one
commercial food is substituted for another. If homemade foods
are being used, they can be replaced by appropriate commercial
foods or another homemade food if other recipes are available
(Chapter 10).
The process is straightforward and simple. The nutrient content of other foods is evaluated to see which food most closely
meets the animals requirements. Assuming comparable palatability, the most acceptable food replaces the previous food. Case
1-3 demonstrates food replacement. This process is greatly
facilitated by the food tables in the feeding healthy dog and cat
chapters (Chapters 12 through 17 for dogs and 19 through 24
for cats) and the feeding clinically ill patient chapters (Chapters
25 through 68). These tables list the key nutritional factor targets and the key nutritional factor contents of commercial foods
commonly marketed for patients at various lifestages and those
having specific diseases.
Changing foods for most healthy dogs and cats is of minor
consequence. Some owners switch their pets from one food to
another daily. Most dogs and cats tolerate these changes.
However, vomiting, diarrhea, belching, flatulence or a combination of signs may occur with sudden, rapid switching of
foods, probably because of ingredient differences. It is prudent,
therefore, to recommend that owners change their pets food
over the course of at least three days. A seven-day period is even
10
Box 1-2. Typical Methods and Units for Expressing a Patients Nutrient Needs and a
Foods Nutrient Content and Methods for Conversion to the Same Units.
When comparing a patients nutrient requirements to a foods

nutrient content to determine adequacy of the food, the same
quantifying units must be used to make the comparison meaningful. The units used for expressing food nutrient content and patient
nutrient requirements are compared in Table 1.
PATIENTS NUTRIENT NEEDS

The three methods for expressing an animals nutrient needs are:
1) dry matter, energy density defined and 2) energy basis and 3)
absolute basis.
Dry matter basis, energy density defined is the percentage or
quantity of a nutrient in the foods dry matter that is needed by the
animal. This measure is the most common method of expressing
an animals nutrient needs. It describes what is required in a food
and indicates an animals nutrient needs. Dry matter refers to that
weight of the food remaining when the water content is subtracted. (Tables 2 and 3 demonstrate methods of calculating dry matter.) Dry matter values are most meaningful if the energy density of
the foods dry matter is specified because most animals eat, or are
fed, to meet their energy requirements.
Energy basis refers to the quantities of nutrients per animals
energy requirement. Units of measure are typically nutrient
amounts per 100 kcal or 1 MJ metabolizable energy (ME).
Occasionally an animals protein, fat and digestible (soluble) carbohydrate needs are expressed as a percentage of the animals total
energy needs (Table 4).
Absolute basis refers to the unit measure (usually weight) of a
nutrient that is needed by an animal in a 24-hour period. These
needs are expressed as quantities per kg of body weight per day.
FOODS NUTRIENT CONTENT

Although there are three methods for expressing an animals nutrient needs, there are four methods for expressing a foods nutrient
content: 1) as fed basis, 2) dry matter basis, 3) dry matter basis,
energy density defined and 4) energy basis.
As fed basis simply refers to the quantity of nutrients in a food
as it is fed. This method ignores moisture and energy content. The
units of measure are percentages or quantities of nutrients per unit
weight (kg) of food.
Dry matter is that weight of the food remaining after the water
content has been subtracted from the as fed amount. Dry matter
basis, therefore, is the amount of nutrients in the foods dry matter. It accounts for variability in water content but not variability in
energy density. The units of measure are percentages or quantities
of nutrients per unit weight (kg) of food dry matter. The usefulness
of dry matter basis is limited because the energy density of individual foods can vary widely. This consideration will be further
explained below (dry matter basis, energy density defined). Tables
2 and 3 show the conversion from as fed basis to dry matter basis.
Dry matter basis, energy density defined is the same as dry matter but specifies a foods energy density, thus accounting for
potential variability. The units of measure are the same as those
used with dry matter basis but are further qualified by expressing
the energy density of the food. For example, recommended nutrient values for canine and feline foods are based on an energy den-
sity of 3.5 and 4.0 kcal ME/g (14.64 and 16.74 kJ ME/g) of food
dry matter, respectively. Dry matter basis, energy density defined is
probably the most widely used method of expressing a foods
nutrient content.
Energy basis refers simply to the amount of nutrients per 100
kcal or 1 megajoule ME of food. Occasionally, a foods protein, fat
and digestible carbohydrate content is expressed as a percentage
of the foods total energy content (Table 4).
Both dry matter basis, energy density defined and energy basis
are reasonably accurate methods of expressing a foods nutrient
content. However, even these methods have limitations.
Animals require less food to meet their energy requirements
when foods with higher energy densities are fed. Under these circumstances, the concentrations of the other nutrients in the food
need to be increased proportionately, to ensure the animal receives
the minimum amount of all nutrients needed in a smaller amount
of food.
When foods with lower energy densities are fed, a lower concentration of the other nutrients may be required, assuming the
dog or cat could eat, or would be fed, enough of the food to meet
its energy requirement. In these instances, the nutrient levels need
to be decreased proportionately, so that the animal would not
receive toxic levels of nutrients in a larger amount of food.
Foods of low energy density, particularly those low in fat and
high in fiber, are usually intended for animals that have a tendency to be overweight. These animals should be fed fewer calories
than animals with normal body weights and body condition scores.
The nutrient content of foods in this category should not be corrected for their lower energy density. During weight loss, there is a
disproportionately lower energy intake relative to the non-energy
nutrients. Although these animals require fewer calories to lose
weight, as far as is known, their requirement for other nutrients has
not changed. Thus, they are essentially being fed the same amount
of dry matter but fewer calories. On an energy basis (g/kcal), the
foods nutrient values will be higher than if the animal had normal
energy requirements.
On the other end of the spectrum are situations in which foods
of high energy density are fed to animals with an unusually high
need for energy-providing nutrients relative to non-energy nutrients. A working sled dog is an example. In this case, on an energy
basis, the foods non-energy nutrient content could be lower than
if the animal had normal energy needs.
CONVERTING TO SAME UNITS

Comparing food on an as fed basis to an animals requirement on
an absolute basis requires: 1) mathematical calculation and 2)
either the energy density of the food or the amounts of the energy-supplying nutrients in the food. Table 5 provides an example of
such a calculation.
When using dry matter basis, energy density defined to compare
foods or to compare foods with animal requirements, the energy
densities must be the same for the comparisons to be meaningful.
Table 6 shows how to convert to the same energy density. In some
cases it will be desirable to convert food nutrient content on an as
fed basis to dry matter basis, energy density defined (Case 1-1).
11
Box 1-2 continued
*Compare these results with those obtained in Table 2 for moist

Table 1. Comparisons of methods to express food nutrient content and animal requirements/allowances for nutritional assessment of food.
Food nutrient content (units)
As fed basis (% or amount of nutrient/kg food)
Dry matter basis (% or amount of nutrient/kg of food dry matter)
Dry matter basis, energy density defined (% or amount of nutrient/kg of food dry matter, at a specified energy density)
Energy basis (amount of nutrient/100 kcal or 1 megajoule ME of
foods energy content)
Dog/cat requirements/allowances (units)
Absolute basis (amount of nutrient/kg animal)
Dry matter basis, energy density defined (% or amount of nutrient/kg of food dry matter, at a specified energy density)
Energy basis (amount of nutrient/100 kcal or 1 megajoule ME of
animals energy requirement)
Table 2. How to convert from as fed basis to dry matter basis.
Step 1. Obtain the foods dry matter content by subtracting the
water content from the as fed amount of the food.
Example A: If a moist food contains 75% water, 25% of the
food is dry matter:
100% as fed 75% water = 25% food dry matter
Example B: If a dry food contains 10% water, 90% of the
food is dry matter:
100% as fed 10% water = 90% food dry matter
Step 2. Convert the percentage as fed nutrient content of the
food to a dry matter basis by dividing the percentage of the nutrient content on an as fed basis by the percentage dry matter.
Example A: If the moist food above contained 10% protein
on an as fed basis, on a dry matter basis it would contain
40% protein:
10% protein as fed basis 25% dry matter = 40%
protein dry matter basis
Example B: If the dry food above contained 18% protein on
an as fed basis, on a dry matter basis, it would contain 20%
protein:
18% protein as fed basis 90% dry matter = 20%
protein dry matter basis
Table 3. Shorthand method for converting from as fed basis to dry
matter basis.
A less accurate, shorthand method for converting from an as fed
basis to a dry matter basis is to simply multiply the percentage
nutrient content on an as fed basis by four for moist foods or add
10% for dry foods. This method is based on the assumption that
moist foods contain approximately 75% water and dry foods contain approximately 10% water. Check the guaranteed analysis on
the product label.
Example A: If a moist food contains 10% protein on an as
fed basis, on a dry matter basis it would contain 40% protein:
10% protein as fed basis x 4 (factor for moist foods) =
40% protein dry matter basis*
Example B: If a dry food contains 18% protein on an as fed
basis, on a dry matter basis it would contain 20% protein:
18% protein as fed basis + 10% (factor for dry food) =
approximately 20% protein dry matter basis*
and dry foods with the same moisture content.

Table 4. How to determine the protein, fat and carbohydrate
content as a percent of the foods total energy content.
Practically speaking, the available energy in foods for dogs and
cats is provided by digestible carbohydrates, protein and fat;
dietary fiber provides little if any energy to these species.
Occasionally an animals need for, or a foods content of, any or all
of these three nutrients is expressed in terms of the fraction of the
total energy they provide. The method is simply another way to
express the relative amounts of these three nutrients. The following example demonstrates how to calculate the percentage of kcal
and kJ from protein, fat and digestible carbohydrate of a pet food.
Nutrient
%
Protein
22
Fat
9
Digestible
carbohydrate 51
Total
-
kcal/g of kJ/g of kcal/g of

nutrient nutrient food**
3.5*
14.64*
0.77
8.5*
35.56*
0.77
3.5*
-
14.64*
-
kJ/g of
food**
3.22
3.20
1.79
3.33
7.47
13.89
% kcal from protein = 0.77 3.33 = 23.1

% kJ from protein = 3.22 13.89 = 23.2
% kcal from fat = 0.77 3.33 = 23.1
% kJ from fat = 3.20 13.89 = 23.0
% kcal from digestible carbohydrate = 1.79 3.33 = 53.8
% kJ from digestible carbohydrate = 7.47 13.89 = 53.8
*Modified Atwater values.

**See Box 1-6, Table 3 for a more detailed explanation for
calculation of energy density of pet foods.
Table 5. Example illustrating the mathematical process required to

compare a foods nutrient content on an as fed basis to an animals needs on an absolute basis.
Example: If an intact male cat weighing 4.5 kg requires 31 mg of
magnesium (Mg) per day (recommended allowance) and the cats
food as fed contains 0.12% Mg, 20% fat, 35% protein and 27%
digestible carbohydrate, does the cat receive adequate amounts
of Mg? The answer is calculated as follows:
1) First find out how much food is to be fed. Because animals are
fed to meet their energy requirements, the first step is to determine the energy density of the food, if it is unknown. This is
done by calculating the amount of energy provided by each of
the energy-supplying nutrients. Using the modified Atwater
energy values of 3.5, 8.5 and 3.5 kcal metabolizable energy
(ME)/g (14.64, 35.56 and 14.64 kJ ME/g) for protein, fat and
digestible carbohydrate respectively (See Box 1-6, Table 2),
multiply the percentage of each nutrient in the food (as fed
basis) by 1 g of food. Then multiply the answer by the energy
density of each nutrient. The sum of the three separate energy
values is the energy density of the food.
In kcal ME/g of food:
35% protein x 1 g food x 3.5 kcal ME/g
= 1.23 kcal ME/g from protein
20% fat x 1 g food x 8.5 kcal ME/g
= 1.70 kcal ME/g from fat
27% digestible carbohydrate x 1 g food x 3.5 kcal ME/g
= 0.95 kcal ME/g from carbohydrate
Sum
3.88 kcal ME/g food (total)
12

Box 1-2 continued
2) The next step is to determine the daily energy requirement

(DER) of the animal. Multiply the formula for resting energy
requirement (RER) by the appropriate modifier for maintenance of an adult cat (Box 6, Table 1).
RER (kcal ME/day) = 70(BWkg)0.75
RER (kJ ME/day) = 293(BWkg)0.75
= 70(4.5 BWkg)0.75 = 216 kcal ME/day
= 293(4.5 BWkg)0.75 = 904 kJ ME/day
Modifier for feline adult maintenance = 1.4 x RER = DER
Modifier for feline adult maintenance = 1.4 x RER = DER
DER (kcal ME/day) = 1.4 x 216 kcal ME = 302 kcal ME
DER (kJ ME/day) = 1.4 x 904 kJ ME = 1,266 kJ ME
3) Determine the amount of food to be fed by dividing the cats
energy requirement by the energy density of the food.
302 kcal ME/day 3.88 kcal ME/g = 78 g food/day
1,266 kJ ME/day 16.18 kJ ME/g = 78 g food/day
4) Determine the amount of Mg provided by the food by multiplying the amount of food fed by the percentage of Mg in the
food.
78 g food x 0.12% Mg = 0.090 g (90 mg) Mg
The amount of Mg provided by the food (90 mg) compared with
the animals requirement of 31 mg indicates more than an adequate (threefold) amount of Mg.
Table 6. How to convert to the same energy density.
Correcting energy densities in order to make valid nutrient comparisons, either between foods or between a food and an animals requirement, is based on the assumption that the relationship between nutrient content and energy density is directly proportional. A simple ratio can be established to generate a multi-
better, as owners increase the proportion of new food and

decrease the proportion of old food (Table 1-1). Nearly all pets
readily tolerate a seven-day transition period. A much longer
transitional period is recommended in cases in which the food
change is known to be significant, the pet has demonstrated a
poor tolerance to such changes in the past or food refusal is
expected (Table 1-1). For example, a long transition schedule is
likely to be needed for an old cat recently diagnosed with kidney disease when the food must be switched from a highly
palatable grocery gourmet food to an appropriate veterinary
therapeutic food.
Table 1-1. Recommended short- and long-term food transition
schedules for dogs and cats.
Short schedule* Long schedule**
Food percentages
Dogs and
Dogs
Cats
Previous
New
cats (days)
(days) (weeks)
food
food
1,2
1-3
1
75
25
3,4
4-6
2
50
50
5,6
7-9
3
25
75
7
10
4
0
100
*Recommended for most healthy dogs and cats.
**Recommended for situations in which the food change is
known to be significant, the dog or cat has demonstrated
low tolerance to such changes in the past or food refusal
is anticipated.
plier that converts the units of the animals requirements to those

of the food; then the animals requirement and the foods nutrient
content can be compared. The multiplier is obtained by dividing
the energy density of the food by the requirement energy density.
Example: Is a food that provides 0.72% potassium and 4 kcal
(16.74 kJ)/g, on a dry matter (DM) basis, adequate for canine
adult maintenance?
1) The requirement for potassium is 0.6% DM basis in an adult
dog food that provides 3.5 kcal (14.64 kJ)/g.
2) Convert the requirement to the same energy density as the
food by generating the multiplier.
Multiplier
= Food energy density requirement energy density
= 4.0 kcal (16.74 kJ)/g DM 3.5 kcal (14.64 kJ)/g DM
= 1.14
3) To obtain the equivalent nutrient requirement for a food providing 4 kcal (14.74 kJ)/g, on a DM basis, multiply the requirement by the multiplier.
Equivalent nutrient requirement
= 1.14 x 0.06% potassium
= 0.68% potassium, 4 kcal (14.74 kJ)/g, on a DM basis
4) The amount of potassium in the food (0.72%) is compared to
the animals equivalent nutrient requirement (0.68%) and is
found to be adequate.
5) The multiplier obtained above (1.14) can be used to convert
the other nutrient requirements to the same basis as the food
to compare the adequacy of their levels, if desired.
After the energy densities of the food and the animals needs are
converted to the same units, the comparison is simple.
Simple Mathematical Ration Balancing

(Pearson Square)
The Pearson square is another useful diet balancing tool. This
handy method can be used to combine any two foods, supplements or ingredients to yield a mixture with a desired nutrient content. Figure 1-4 shows how the Pearson square
method is used to balance a diet. Heres how to use the
Pearson square:
A small square is drawn and the desired nutrient concentration of the proposed mixture is written in the middle of the
square.
The nutrient concentration of one component of the mixture is written at the upper left corner of the square.
The nutrient concentration of the other component of the
mixture is written at the lower left corner of the square.
The nutrient values at the corners are subtracted from those
in the center of the square. The smaller number is always
subtracted from the larger and the differences written diagonally at the right corners of the square.
The differences are added together and the sum is written
below each difference as the denominator of a fraction.
The fractions are converted to percentages. These percentages are the proportion of each component of the mixture in
the corners directly to the left. When combined in those
percentages, the constituent components will yield a mixture
13
Box 1-3. Four Ways to Determine the Nutrient Content of a Food.

The nutrient content of a food can be determined one of four ways:
1) Obtain the target values from the manufacturers of commercially
prepared foods.
2) Order a laboratory analysis.
3) Calculate the content based on the published values for the ingredients.
4) Use the information found in the label guaranteed analysis and typical analysis (Chapter 9).
Only the first three are recommended because of the severe limitations of label guarantees and typical analyses.
Most pet food manufacturers, upon request, will supply target values for the nutrient content of their products. This approach is simple
and inexpensive. Although these values usually reflect actual average
nutrient levels, occasionally they vary significantly from actual values,
thus this method is not always accurate. No laws govern the accuracy of target nutrient levels. In most instances, however, these values
will be adequate.
The basic laboratory analysis is the proximate analysis (Figure 53), which provides the percentage moisture, crude protein, crude
fat, ash and crude fiber in a food and allows calculation of the
digestible carbohydrate fraction (also referred to as the nitrogenfree extract [NFE]). Most commercial laboratories will also conduct
more expansive nutrient analyses including amino acids, fatty acids,
minerals, vitamins and various fiber fractions. Analysis of food samples for nutrient content is very straightforward and usually accurate. Limitations include proper sampling, the potential issue of
analytical variance for certain nutrients and the expense and time
involved for a complete analysis.
Calculations require nutrient contents of ingredients and a formula
for the food in question. Published average nutrient contents of ingre-
dients can be obtained from NRC nutrient requirement booklets and

listings of average nutrient contents of human foods. This approach
would likely be used for determining the nutrient content of a homemade food. One limitation of this method is the time and knowledge
required to do such calculations. Another limitation is accuracy (i.e.,
how closely the published average nutrient content of the ingredients
represents the ingredients actual nutrient content). Values can vary
markedly.
The use of guaranteed analyses (United States and Canada) or typical analyses (Europe) listed on the label of commercially prepared
foods as a means of establishing nutrient content has severe limitations:
In the case of guaranteed analysis, the quantities listed are minimums or maximums only.
It is only necessary to list a fraction of the nutrients in the food (e.g.,
guaranteed analysis only requires crude protein, crude fat, crude fiber
and moisture; typical analysis only requires crude protein, crude fat,
crude fiber, ash and moisture if more than 14%).
Guaranteed analysis values are not the nutrient content of the food.
They are a guarantee by the manufacturer that the food contains not
more, or less, than the stated amount. Label guarantees can provide
a general idea of the nutrient content for a limited number of nutrients
and the classification of the food (growth-type food, maintenance food,
etc.).
Use caution when using guaranteed and typical analyses to compare specific nutrient levels between foods. When such comparisons
are made, be sure to compare similar forms of foods (i.e., dry to dry
or moist to moist). Label guarantees are listed on an as fed basis.
Different forms of food can be compared if the foods are converted to
the same moisture or energy content (Tables 2, 3 and 6 in Box 1-2).
Box 1-4. Computerized Food Evaluation/Balancing Programs.

There are two categories of food evaluation/balancing software programs listed below. The category entitled Veterinary Clinical Nutrition
Software is a special application designed for use by veterinarians and veterinary nutritionists. It contains commercial pet food and human
food nutrient data that enable users to select foods and make feeding and weight-loss feeding plans for individual patients. Additional tools
for automatic formulation of homemade pet foods from recipes are also available.
A cautionary reminder: software programs are tools intended to make the mathematical work of food evaluation/balancing/formulation
easier and faster. Their accuracy depends entirely on the accuracy of the databases from which they are working and they do not account
for nutrient availability regarding ingredient sourcing and cooking, nor do they ensure a palatable food.
Veterinary Clinical Nutrition
Software Programs
Commercial Formulation
Software Programs
Davis Veterinary Medical

Consulting, PC
707 Fourth Street, Suite 307
Davis, CA 95616
Phone: (530) 756- 3862 or
(888) 346-6362
Fax: (530) 756-3863
E-mail:
[email protected]
www.balanceit.com
Balance IT
Creative Formulation
Concepts, LLC
1831 Forest Drive, Suite H
Annapolis, MD 21401
Phone: (410) 267-5540
Fax: (410) 267-5542)
http://creativeformulation.com
Concept5
Feedsoft Formulation
14001 Dallas Parkway,
Suite 1200
Dallas, TX 75240
Phone: (866) 363-7843
Fax: (972) 231-9096
http://feedsoft.com
Agricultural Software
Consultants, Inc.
2726-600 Shelter Island Drive
San Diego, CA 92106
Phone: (619) 226-2600
Fax: (619) 226-7900
Mixit-Win 5
Format International, Ltd.
Format House
Poole Road
Woking
Surrey England GU21 6DY
Phone: +44 (0)1483 726081
Fax: +44 (0)1483 722827
www.format-international.com
New Century
Format International, Inc.
10715 Kahlmeyer Drive
St. Louis, MO 63132
Phone: (888) 628-5683
Fax: (314) 428-4102
www.format-international.com
New Century
14
Box 1-5. Food Formulation and

Extensive Food Balancing.
It is not the intention of this book to teach complete food formulation or extensive food balancing. Few practitioners
need to know how to formulate balanced foods from
scratch. Nutrient requirement information is readily available; however, accurate/relevant ingredient nutrient databases, an understanding of the availability of nutrients in
various ingredients, knowledge of the effect of cooking on
nutrient availability and knowledge of all of these variables
on palatability are complex issues. Such information is not
readily available, and usually requires assimilation by a team
of experts, including veterinarians, nutritionists and food scientists to ensure proper formulation of complete and balanced foods.
Fortunately, numerous complete pet food options are
readily available from commercial pet food manufacturers.
Many homemade food recipes have also been published. Be
sure to obtain homemade food recipes from reliable sources
as discussed in Chapter 10.
As an example, the Pearson square can be used to solve the

following problem: How much calcium carbonate containing
36% calcium must be added to a meat-based food to increase
its calcium content from 0.01% to 0.3% on an as fed basis?
Assume you are making 5 kg of the mixture. The problem is set
up and worked as follows:
% calcium in
meat-based food
= 0.01
36.0 0.3 = 35.70

% calcium
required = 0.3
% calcium in
calcium carbonate
= 36.0
0.30 0.01 =
0.29
35.99
The final step converts fraction to percentages by dividing the

numerator of the fractions by the denominator and multiplying
by 100.
Meat-based food: (35.70 35.99) x 100 = 99.19%
Calcium carbonate: (0.29 35.99) x 100 = 0.81%
If the total mixture is 5 kg, then 99.19% (4.96 kg) should be
a meat-based food and 0.81% (0.04 kg, or 40 g) should be
calcium carbonate.
Figure 1-4. Example of how to use the Pearson square.
having the same concentration as the number in the center

of the square.
adequacy statement on the products label (Chapter 9).

Published clinical trials and case reports for commercial veterinary therapeutic foods can be obtained from the products
manufacturer. As mentioned above, manufacturers addresses
and toll-free phone numbers are found on pet food labels.
However, some brands of these products have passed regulatory agency (AAFCO) prescribed feeding tests although the
product label may not include such information.
Commercial pet foods that have undergone AAFCO-prescribed or similar feeding tests provide reasonable assurance of
nutrient availability and sufficient palatability to ensure
acceptability (i.e., food intake sufficient to meet nutrient
needs). Feeding tests also provide some assurance that a product will adequately support certain functions such as gestation,
lactation and growth. However, even controlled animal testing
is not infallible.
In the United States, the AAFCO testing protocol for adult
maintenance lasts six months, requires only eight animals per
group and monitors a limited number of parameters (Chapter
9). Passing such tests does not ensure the food will be effective in preventing long-term nutrition/health problems or
detect problems with prevalence rates less than 15%.
Likewise, these protocols are not intended to ensure optimal
growth or maximize physical activity. Besides feeding tests,
AAFCO prescribes other methods to assure nutritional adequacy (Chapter 9). Thus, in addition to meeting AAFCO
requirements, the food should be evaluated to ensure that key
nutritional factors are at levels appropriate for promotion of
long-term health or for optimal performance. Few, if any,
homemade recipes have been animal tested according to prescribed feeding protocols.
Although not considered feeding tests, the personal observations of veterinarians and pet owners about the performance of
specific foods or recipes can be valuable. Such experiences are,
in a sense, uncontrolled feeding tests. Through experience, veterinarians and pet owners form impressions about a foods value
in disease management, its ability to support various lifestages
and work, its palatability, resultant stool quality and skin and
coat benefits. Limitations of personal observations include the
lack of controls and the length of time it takes (months to years)
to gather sufficient information about a wide variety of products. Also, some commercial products are continuously
improved; therefore, yesterdays product does not necessarily
reflect the capabilities of the same product today. However,
personal observations can augment controlled feeding tests
such as published clinical trials and regulatory agency prescribed feeding protocols for healthy pets.
Physical Evaluation of the Food

Feeding Tests and Clinical Trials
Evaluation of the product label of commercial foods can provide feeding test information. Determining if a food has been
evaluated in clinical trials is a more complicated matter and is
covered in Chapter 9 and in various clinical chapters.
Whether or not commercial foods for healthy pets have been
animal tested can usually be determined from the nutritional
Conducting a physical evaluation of the food is of limited usefulness. It can provide information about a foods consistency
and whether or not there are extraneous materials in the food.
It can also determine package quality, which may or may not
reflect product quality. Physical evaluation of the food is probably most useful for assessing whether or not the food has
spoiled (Chapter 11).
15
Box 1-6. A Method for Calculating the Food Dosage Estimate.

Calculations to estimate food dosage are based on the assumption
that if a food contains the proper proportions of nutrients relative to
its energy density, and is fed to meet an animals energy requirement, then the animals requirements for non-energy nutrients will
automatically be met. This calculation has three steps:
1) Estimate the energy requirement of the animal (Table 1).
2) Determine the energy density of the food (kcal or kJ ME/g food,
as fed basis). Sources include product labels, product literature,
contacting the products customer service department by phone
or e-mail (phone numbers or e-mail addresses can often be
found on the product label). The energy density can be calculated using Atwater values (Tables 2 and 3).
3) Divide the energy requirement of the patient by the energy density of the food to determine the daily amount to feed (food
dosage).
Canine DER
Maintenance (1.0 to 1.8 x RER)
Neutered adult
= 1.6 x RER
Intact adult
= 1.8 x RER
Inactive/obese prone
= 1.2-1.4 x RER
Weight loss
= 1.0 x RER
Critical care
= 1.0 x RER
Weight gain
= 1.2-1.8 x RER at ideal weight
Table 1. Calculation of energy requirements.
Lactation
Lactation is nutritionally demanding and the physiologic and nutritional equivalent of heavy work.
Recommend 4 to 8 x RER (depending on number of puppies nursing) or free-choice feeding.
The following table may also be used to estimate the DER of lactating bitches:
Calculation of daily energy requirement (DER) is based on the resting energy requirement (RER) for the animal modified by a factor to
account for normal activity or production (e.g., growth, gestation,
lactation, work). RER is a function of metabolic body size. RER is
calculated by raising the animals body weight in kg to the 0.75
power. The average RER for mammals is about 70 kcal/day/kg
metabolic body size: RER (kcal/day) = 70(BWkg)0.75 or 30(BWkg) +
70 (if the animal weighs between 2 and 45 kg). RER values can
also be obtained from Table 5-2, Part 3. Expressed in kJ, the average RER for mammals is about 293(BWkg)0.75. These energy
requirements should be used as guidelines, starting points or estimates of energy requirements for individual animals and not as
absolute requirements.
Feline DER
Maintenance (0.8 to 1.8
Neutered adult
Intact adult
Inactive/obese prone
Weight loss
Senior adult (7-11 years)
Very old adult (>11 years)
Critical care
Weight gain
x RER)
= 1.2-1.4 x RER
= 1.4-1.6 x RER
= 1.0 x RER
= 0.8 x RER
= 1.1-1.4 x RER
= 1.1-1.6 x RER
= 1.0 x RER
= 1.2-1.8 x RER at ideal weight
Gestation
Energy requirement increases linearly during gestation in cats.
Energy intake should be increased to 1.6 x RER at breeding and
gradually increased through gestation to 2 x RER at parturition.
Free-choice feeding of pregnant queens is also recommended.
Lactation
Lactation is nutritionally demanding and the physiologic and nutritional equivalent of heavy work. Recommend 2 to 6 x RER
(depending on number of kittens nursing) or free-choice feeding.
The following table may also be used to estimate the DER of lactating queens:
Weeks of lactation DER
Weeks 1-2 RER + 30% per kitten
Week 3
RER + 45% per kitten
Week 4
Week 5
Week 6
Growth
Daily energy intake for growing kittens should be about 2.5 x RER.
Free-choice feeding is recommended.
Work
Light work
Moderate work
Heavy work
= 1.6-2.0 x RER
= 2.0-5.0 x RER
= 5.0-11.0 x RER
Gestation
First 42 days: feed as an intact adult.
Last 21 days: use 3 x RER. (This quantity may need to be
increased to maintain normal body condition for some dogs, especially larger breeds.)
Puppies (No.)
1
2
3-4
5-6
7-8
9
DER
3.0 x RER
3.5 x RER
4.0 x RER
5.0 x RER
5.5 x RER
6.0 x RER
Growth
Daily energy intake for growing puppies should be 3 x RER from
weaning until four months of age.
At four months of age energy intake should be reduced to 2 x RER
until the puppy reaches adult size.
Table 2. Energy available from protein, fat and digestible carbohydrate (nitrogen-free extract).
Metabolizable energy (kcal/g)
Crude fat
9.4 x digest.*
Digestible
carbohydrate
4.15 x digest.*
8.5**
3.5**
Crude fat
39.33 x digest.*
Digestible
carbohydrate
17.36 x digest.*
35.56**
14.64**
Species Crude protein

All*
4.4 x digest.*
Dogs
and cats**
3.5**
Metabolizable energy (kJ/g)
Species Crude protein
All*
18.41 x digest.*
Dogs
and cats** 14.64**
Key: digest. = digestibility

*The most accurate value to use when the digestibility of the three
nutrients is known. (Adapted from Lewis et al, 1987)
**Modified Atwater values (Dog Food Nutrient Profiles and Cat
Food Nutrient Profiles). Association of American Feed Control
Officials 2007.
16

Box 1-6 continued
Table 3. Example calculation of caloric density of a pet food.*

Analysis
Protein
Fat
Fiber***
Moisture
Ash***
Digestible
carbohydrate
%
22
9
3
10
5
x
x
x
x
x
51
Metabolizable
kcal/g
of nutrient**
3.5
8.5
0
0
0
energy (kcal)
kcal/g
of food
=
0.77
=
0.77
=
0
=
0
=
0
3.5
3.32
Total
Analysis
Protein
Fat
Fiber***
Moisture
Ash***
Digestible
carbohydrate
Total
1.79
%
22
9
3
10
5
x
x
x
x
x
51
Metabolizable energy (kJ)

kJ/g
kJ/g
of nutrient**
of food
14.64
=
3.22
35.56
=
3.20
0
=
0
0
=
0
0
=
0
14.64
7.47
13.89
3.33 kcal/g (13.89 kJ/g) x amount of food/measuring cup

= kcal/measuring cup
*As fed basis.

**From Table 1-8.
***If not available, these may be estimated as 3% fiber and
9% ash in dry foods, 1% fiber and 6% ash in soft-moist
foods and 1% fiber and 2.5% ash in moist foods.
Percent digestible carbohydrate (nitrogen-free extract)
usually is not stated but can be calculated on an as fed
basis by subtracting the percent protein, fat, fiber, moisture and ash from 100.
If the nutrient percentages were obtained from the label
guarantee, multiply the foods caloric density by 1.2 for
moist pet foods and 1.1 for semi-moist and dry pet foods.
In this example, 3.33 (13.89 kJ) x 1.1 = 3.66 kcal (15.28
kJ)/g of dry food.
An 8-oz. (volume) measuring cup holds 3 to 3.5 oz. by
weight (85 to 100 g) of most dry pet foods or 3.5 to 5 oz.
by weight (100 to 150 g) of most semi-moist pet foods. It
is more accurate to use the average weight of three individual measuring cups of food in determining kcal or
kJ/cup.
Label Evaluation
The ingredient panel of the pet food label provides general
information about which ingredients were used and their relative amounts. The ingredients used in the product are listed in
descending order by weight in many countries. The ingredient
panel can be useful if specific ingredients are contraindicated
for certain animals or an owner has an ingredient concern.
However, the quality of the ingredients cannot be determined
from the label and there is much misinformation and, as a
result, misunderstandings about pet food ingredients (Chapter
8). As mentioned above, the presence or absence of specific
protein sources or other ingredients in a food can be obtained

from the product label.
Depending on the country, product labels will also provide
information that indicates by what means the product has been
shown to be nutritionally adequate (Chapter 9).
Assess and Determine the Feeding Method

Feeding methods relate directly to the physiologic or disease
state of the animal and the food or foods being fed. Thus, the
information obtained by assessing the animal and the food is
fundamental to assessing the feeding method. There are at
least three things to consider regarding feeding methods: 1)
feeding route, 2) amount fed and 3) how the food is offered
(when, where, by whom and how often). In addition, feeding
factors that affect compliance should be considered, such as
whether or not the animal has access to other foods and who
provides the food.
Feeding Route
Whether or not the feeding route is appropriate depends on
the animals condition. Although most animals are able to feed
themselves, orphans and some critical care patients may
require assistance. Assisted-feeding methods are described in
detail in Chapters 25 and 26. Assisted-feeding methods
include enteral feeding by syringe or tube (several approaches)
and parenteral feeding.
Amount Fed
The nutrient needs of an animal are met by a combination of
the nutrient levels in the food and the amount of food offered
and eaten. Even if a food has an appropriate nutrient profile,
significant over- or undernutrition could result if too much or
too little is consumed. Thus, it is important to know if the
amount being consumed is appropriate.
The amount of food offered should be determined when
taking the patients history. Although many animals are fed
free choice, owners should still be able to provide a reasonable
estimate of the actual amount being consumed. The owner
may need to return home and measure the amount the pet
consumes to provide an accurate report or estimate the amount
based on the purchasing frequency of bags or cans. The
amount actually being consumed can then be compared with
the amount that should be fed. If the animal in question has a
normal BCS (3/5) and no history of weight changes, the
amount fed is probably appropriate. Exceptions to this generalization include growing animals, animals that are gestating
or lactating and hunting dogs and other canine athletes early
in the athletic event season.
The appropriate amount to feed can be difficult to determine
precisely, but can be estimated. For most commercial pet foods,
food dosage estimates can be found in the feeding guidelines on
the product label. However, food dosages can be calculated if
guidelines are unavailable. The precision of feeding guidelines
or calculated food dosages is limited because the efficiency of
food use varies among individuals because of differences in
physical activity, metabolism, body condition, insulative charac-
teristics of the coat and external environment. Even when environmental conditions and physical activity are similar, sizable
individual differences can exist.
Figure 1-5 contains data generated from several controlled
studies about the amount of food (energy content standardized)
consumed by mature, non-reproducing dogs and cats kept in
kennels or runs under similar environmental conditions while
maintaining body weight. The total amount of energy needed
by dogs and cats for maintenance, even under similar environmental conditions can vary two- to threefold. Even when the
extremes are excluded (the top and bottom 2.5%), the amount
of energy needed varied more than twofold (Lewis et al, 1987).
Therefore, a commercial products amount to feed guideline or
a calculated food dosage should only be considered an estimate
or a starting point that may very likely need adjustment.
Calculations to estimate food dosage are based on the
assumption that if a food contains the proper proportions of
nutrients relative to its energy density, and is fed to meet an animals energy requirement, then the animals requirements for
non-energy nutrients will be met automatically. This is an
important concept. Box 1-6 demonstrates the method for calculating food dosage estimates. Case 1-2 includes an example
of a food dosage problem.
How the Food is Offered

The amount fed is usually offered in one of three ways: 1) freechoice feeding (dogs and cats), 2) food-restricted meal feeding
(dogs and cats) and 3) time-restricted meal feeding (dogs).
The number of feedings per day must be considered when the
last two methods are used.
Free-choice feeding (also referred to as ad libitum or self
feeding) is a method in which more food than the dog or cat
will consume is always available; therefore, the animal can eat as
much as it wants, whenever it chooses. The major advantage of
free-choice feeding is that it is quick and easy. All that is necessary is to ensure that reasonably fresh food is always available.
17
Free-choice feeding is the method of choice during lactation.

Free-choice feeding also has a quieting effect in a kennel and
timid dogs have a better chance of getting their share if dogs are
fed in a group.
Disadvantages include: 1) anorectic animals may not be
noticed for several days, especially if two or more animals are
fed together, 2) if food is always available, some dogs and cats
will continuously overeat and may become obese (such animals
should be meal fed) and 3) moist foods and moistened dry
foods left at room temperature for prolonged periods can spoil
and are inappropriate for free-choice feeding (Chapter 11).
When changing a dog from meal feeding to free-choice
feeding, first feed it the amount of the food it is used to receiving at a meal. After this food has been consumed and the dogs
appetite has been somewhat satisfied, set out the food to be fed
free choice. This transitioning method helps prevent engorgement by dogs unaccustomed to free-choice feeding.
Engorgement is generally not a problem when transitioning
cats to free-choice feeding. Although dogs and cats unaccustomed to free-choice feeding may overeat initially, they generally stop doing so within a few days, after they learn that food
is always available. Avoid taking the food away at any time
during this transition period. Each time food is taken away
increases the difficulty in changing the animals to a free-choice
feeding regimen.
With food-restricted meal feeding, the dog or cat is given a
specific, but lesser, amount of food than it would eat if the
amount offered were not restricted (i.e., free choice). Timerestricted meal feeding is a method in which the animal is given
more food than it will consume within a specified period of
time, generally five to 15 minutes. Time-restricted meal feeding is of limited usefulness with dogs and has little if any practical application in cats. Many dogs can eat an entire meal in
less than two minutes. Both types of meal feeding are repeated
at a specific frequency such as one or more times a day. Some
people combine feeding methods, such as free-choice feeding a
Figure 1-5. Variation in expected energy intake required to maintain optimal body weight in dogs and cats. Data were collected from 120 dogs
and 76 cats kept under similar conditions and fed the amount of a variety of commercial pet foods necessary to maintain body weight
(Adapted from Lewis et al, 1987).
18
dry or semi-moist food and meal feeding a moist food or other

foods such as meat or table scraps.
Food consumption resulting from frequent meal and freechoice feeding has several advantages. Small meals fed frequently throughout the day result in a greater loss of energy
due to an increase in daily meal-induced heat production.
Also, providing frequent small meals generally result in greater
total food intake than does less frequent feeding (Mugford and
Thorne, 1980). Frequent feeding of small meals benefits animals with dysfunctional ingestion, digestion, absorption or use
of nutrients.
Frequent feeding is also desirable in normal animals that
require a high food intake. Puppies and kittens less than six
months old, some dogs engaged in heavy work (high levels of
physical activity), dogs and cats experiencing ambient temperature extremes, bitches and queens during the last month of
gestation and during lactation should be fed at least three
times per day to ensure that their nutritional needs are met.
These animals may require one and one-half to four times as
much food per unit of body weight than most normal adult
dogs and cats. A reduced frequency might limit total food
intake in these situations. Also, more frequent feeding during
periods of variable appetite suppression, such as occurs with
psychologic stress or high ambient temperatures, helps ensure
adequate food intake.
Most clinically normal adult dogs that are not lactating,
working or experiencing stress will have a sufficient appetite
and physical capacity to consume all of the food required daily
in a single 10-minute period (assuming food of typical nutrient
density [about 3.5 kcal/g or 14.64 kJ/g dry matter]). Cats are
less likely to eat their entire meal in one 10-minute sitting, but
once-a-day feeding is adequate for most healthy adults.
Although many dogs and cats are fed once daily without
noticeable detrimental effects, at least twice daily feeding is
generally recommended.
In summary, how the food is provided and how often it is fed
depend on the animals condition and in some cases the lifestyle
of the owner. Each animals situation will dictate which feeding
method is most desirable (free choice, time-restricted meal
feeding or food-restricted meal feeding). For many physiologic
and disease conditions this consideration will not be important.
For others it will be very important. Recommendations for the
best method of providing the food and the number of times per
day the food is offered are included in each individual chapter.
Enabling compliance includes limiting access to other foods

and knowing who provides the food. An animal from a multipet household may have access to the other pets food. If so,
such access needs to be denied or limited. Restriction can be
difficult in some homes. In such cases the veterinary health care
team and pet owner may need to compromise.
Compliance can be eroded if everyone in the family does not
support the feeding plan. Whoever feeds the pet must understand the consequences when the wrong foods are fed or even
the right foods are fed in the wrong amounts. Client education
is essential for the successful outcome of any feeding plan.
Specific client education must be provided for feeding healthy
pets and for those with specific disease problems. Both oral and
written instructions encourage compliance with feeding plans.
Veterinarians and their health care teams should actively
involve clients in the formulation of the feeding plan to ensure
commitment to the plan. The hospital staff should strive to
uncover issues that clients may have about the feeding plan and
negotiate mutually acceptable solutions. Open communication
about the clients and the health care teams objectives, concerns
and shared responsibilities is necessary for successful implementation of the feeding plan. Authoritarian approaches are
unlikely to be effective because they discount the high degree of
independent decision making that clients have based on their
own perceptions of nutrition. Veterinarians and their health
care teams can guide clients and enable them to make informed
decisions. For more about compliance see Chapter 3.
Compliance
The references for this chapter can be found at

www.markmorris.org.
Owner compliance is necessary for effective clinical nutrition.

Feeding methods should reinforce or enable compliance.
REASSESSMENT
Finally, monitoring, or reassessing the animal, should be performed at appropriate intervals to evaluate the effectiveness of
the feeding plan. For patients undergoing intensive care,
reassessment may need to be done every few hours, whereas
pets in a health maintenance program could be reassessed
annually. Reassessment signals the initiation of the iterative
step of the clinical nutrition process. Involving the client in an
action plan is an essential component of the veterinarian-client
relationship. The reader is referred to the remaining chapters of
this book for information about specific feeding plans and practices according to nutritional needs of pets in health and in specific diseases.
REFERENCES
19
CASE 1-1
Calcium Supplementation in a Great Dane Puppy
Michael S. Hand, DVM, PhD, Dipl. ACVN*
Hills Science and Technology Center
Topeka, Kansas, USA
Patient Assessment
A 10-week-old male Great Dane puppy weighing 15 kg was examined as part of its routine health maintenance procedures. The
results of a physical examination were normal. The puppys body condition score was 3/5.
Assess the Food and Feeding Method

The puppy is fed a dry lamb and rice-based commercial food. The owner feeds the puppy four 8-oz. measuring cups of food daily.
The owner also provides eight calcium tablets daily as a supplement to ensure enough calcium. A phone call to the pet food companys customer service department determined that the foods calcium content is 2.3% and that it provides 3.6 kcal/g (15.1 kJ/g)
on an as fed basis (10% moisture). The customer service department also indicates that the food density is 94 g/cup. Product literature included with the calcium tablets indicates that each tablet provides 0.5 g of calcium carbonate, and that calcium carbonate
contains 36% calcium (0% moisture). The owner asked if this is enough calcium for the puppy.
Questions
1.
2.
3.
4.
5.
How many g of food and how many g of calcium carbonate are being fed (dry matter [DM])?
Determine the total amount of calcium (DM) provided by the food and supplement.
Determine the percentage of calcium in the DM of the combined food and supplement.
Convert the energy density on an as fed basis to DM.
Does the combination of the food and supplement meet the calcium requirement for a giant-breed puppy?
Answers and Discussion

1. Four cups x 94 g/cup = 376 g of food. Because the two components being evaluated have differing moisture contents (food =
90% DM and calcium carbonate tablets = 100% DM), it is advisable to convert the food to DM at this point: 376 g of food on
an as fed basis x 90% DM = 338 g food DM.
The owner feeds eight calcium tablets daily. The calcium carbonate source has no moisture so as fed basis equals DM: eight
calcium tablets x 0.5 g calcium carbonate per tablet = 4 g calcium carbonate (as fed and DM).
2. According to the manufacturer, the food provides 2.3% calcium on an as fed basis. To convert this to DM, divide the as fed percentage by the DM percentage: 2.3% calcium as fed basis 90% DM = 2.6% calcium DM.
We have already determined that the calcium tablets provide 4 g calcium carbonate and that calcium carbonate contains 36%
calcium. To determine how much calcium is provided by each component, multiply the amount of each component being fed
by the amount of calcium in each component and add them:
338 g food dry matter x 2.6% calcium = 8.8 g calcium
4 g calcium carbonate x 36% calcium = 1.4 g calcium
10.2 g total
calcium (DM)
3. Total food DM is the sum of the two components:
338 g food DM + 4 g calcium carbonate DM =
342 g total food DM
10.2 g total calcium (DM) 342 g total food DM =
3.0% calcium
4. We need to consider the effect of the supplemental calcium source on the energy density of the food and convert the energy density to DM. In this case, we ignore any dilutional effect the 4 g of calcium carbonate has on the energy density of the food because
it would be inconsequential (4 g 342 g = 1%). To convert 3.6 kcal ME/g (15.06 kJ ME/g) as fed to DM, as described previ-
20
ously, divide the as fed basis by the DM percentage:

3.6 kcal ME/g as fed 90% DM = 4 kcal ME/g (DM), or
15.06 kJ ME/g as fed 90% DM = 16.74 kJ ME/g (DM)
Thus, the total food contains 3.0% DM calcium and provides 4 kcal ME/g (16.74 kJ) DM.
5. To compare a foods nutrient content with a recommended target level requires that the energy density of the food and that specified for the target level be similar or the same. Calcium is a key nutritional factor (nutrient of concern) for large- and giantbreed puppies. Calcium levels in foods intended for large- and giant-breed growth should not exceed 1.2% DM in foods that
provide <3.8 kcal ME/g (<15.90 kJ) (Chapter 33). As described above, the conversion is made by generating a multiplier that
converts the requirement to the same energy density as the food. This is done by dividing the food energy density by the requirement energy density and multiplying the requirement by the multiplier: 4 kcal ME/g 3.6 kcal ME/g = 1.1 (multiplier), or 16.74
kJ ME/g 15.06 kJ ME/g = 1.1 or 1.1 x 1.2% maximum = 1.32% maximum.
In this case, the combined food and supplement are providing excessive calcium for this giant-breed puppy (3% in food vs. 1.32%
maximum recommended) (Chapter 33).
*Current address: Arroyo Hondo, New Mexico, USA.
CASE 1-2
Food Dosage Estimate for a Lactating Queen
Michael S. Hand, DVM, PhD, Dipl. ACVN*
Hills Science and Technology Center
Topeka, Kansas, USA
Patient Assessment
A 4-kg, three-year-old queen is presented for weight loss. The cat is nursing five, three-week-old kittens. The queens body condition score is 2/5 and the patient record indicates the cat has lost 1 kg since its postpartum checkup.

The cat is being fed one cup of a commercial dry food daily, free choice. The food is suitably balanced for feline lactation. The energy density of the food is 535 kcal metabolizable energy (ME)/cup (2,238 kJ ME/cup) on an as fed basis.
Questions
1. What is this queens estimated daily energy requirement (DER)?
2. What should the food dosage be based on this queens DER?
Answers and Discussion

1. Resting energy requirement (RER) (kcal ME/day) = 70(BWkg)0.75
= 70(4 kg)0.75 = 70(2.83) = 198 kcal ME/day, or
= 293(4 kg)0.75 = 293(2.83) = 829 kJ ME/day
Modifier for adult feline = 1.5 x RER = DER
DER = 1.5 x 198 kcal ME/day = 297 kcal ME/day, or
1.5 x 829 kJ ME/day = 1,243.5 kJ ME/day
Modifier for feline lactation = (1 + 0.25[number kittens nursing]) x DER
= [1 + 0.25(5)] x 297 kcal ME/day
= 2.25 x 297 kcal ME/day = 668 kcal ME/day, or
2.25 x 1,243.5 kJ ME/day = 2,798 kJ ME/day
2. The food being fed has a nutrient profile that is satisfactory for feline lactation. The energy density of the food is 535 kcal (2,238
kJ) ME/cup. Divide the energy requirement by the energy density of the food to determine how much to feed the cat:
668 kcal ME/day requirement 535 kcal ME/cup = 1.25 cups/day, or
2,798 kJ ME/day requirement 2,238 kJ ME/cup = 1.25 cups/day
According to these calculations the cat is being underfed. The amount offered free choice should be increased by at least
25%.
*Current address: Arroyo Hondo, New Mexico, USA.
21
CASE 1-3
Altering the Food and Feeding Method for a Young Rottweiler
Rebecca L. Remillard, PhD, DVM, Dipl. ACVN
Angell Animal Medical Center
Boston, Massachusetts, USA
Patient Assessment
A four-month-old, female Rottweiler was examined for diarrhea of five days duration. The puppy had escaped from a fenced yard
on trash pickup day and the owners suspected it had eaten garbage. The puppy appeared bright and alert, weighed 18 kg and had
a body condition score of 3/5. The results of the physical examination were normal except for fluid-filled intestines on abdominal
palpation. The owners described the stools as being small volume but frequent (eight to 10/day) and liquid with some bright red
blood and mucus. A fecal examination was negative for intestinal parasites.

The puppy was fed a commercial dry puppy food three times per day until its escape. The puppy still had a good appetite, but
seemed to be drinking more than usual amounts of water. On Day 1 of the diarrheic episode, the veterinarian examined the puppy
and asked the owner to feed a moist commercial veterinary therapeutic food (poultry, egg and rice based) with moderate fat (13%)
and low fiber (<1%) (Prescription Diet i/d Caninea). However, the diarrhea had not resolved after feeding the food for three days.
Question
What is the appropriate food and feeding method for this patient with large bowel diarrhea?
Answer and Discussion

The food was replaced with a moist commercial veterinary therapeutic food that contained 13% fat and 12% crude fiber on a dry
matter basis (Prescription Diet w/d Caninea). The owners were instructed to feed the puppy at its estimated resting energy requirement (805 kcal [3,368 kJ]/day) with two cans of the new food divided into four meals per day for one to two days; then to feed at
the estimated daily energy requirement (1,600 kcal/day [6,694 kJ]) with four cans of the new food divided into three to four meals
per day for another two days. The owners were instructed to return for a recheck if the puppy did not have a normal stool by the
fourth day. If the puppys stool was normal, the owners were instructed to transition the food back to the original puppy food using
the short schedule outlined in Table 1-1.
Progress Notes
No stool was produced within the first 24 hours of feeding the higher fiber food. By the end of the second day the dog had a normal bowel movement with no blood or mucus. The owners continued to feed the higher fiber food for another two days as instructed. The puppy was then switched back to the dry puppy food over seven days with no problems.
Endnote
a. Hills Pet Nutrition Inc., Topeka, KS, USA.
21
CASE 1-3
Altering the Food and Feeding Method for a Young Rottweiler
Rebecca L. Remillard, PhD, DVM, Dipl. ACVN
Angell Animal Medical Center
Boston, Massachusetts, USA
Patient Assessment
A four-month-old, female Rottweiler was examined for diarrhea of five days duration. The puppy had escaped from a fenced yard
on trash pickup day and the owners suspected it had eaten garbage. The puppy appeared bright and alert, weighed 18 kg and had
a body condition score of 3/5. The results of the physical examination were normal except for fluid-filled intestines on abdominal
palpation. The owners described the stools as being small volume but frequent (eight to 10/day) and liquid with some bright red
blood and mucus. A fecal examination was negative for intestinal parasites.

The puppy was fed a commercial dry puppy food three times per day until its escape. The puppy still had a good appetite, but
seemed to be drinking more than usual amounts of water. On Day 1 of the diarrheic episode, the veterinarian examined the puppy
and asked the owner to feed a moist commercial veterinary therapeutic food (poultry, egg and rice based) with moderate fat (13%)
and low fiber (<1%) (Prescription Diet i/d Caninea). However, the diarrhea had not resolved after feeding the food for three days.
Question
What is the appropriate food and feeding method for this patient with large bowel diarrhea?
Answer and Discussion

The food was replaced with a moist commercial veterinary therapeutic food that contained 13% fat and 12% crude fiber on a dry
matter basis (Prescription Diet w/d Caninea). The owners were instructed to feed the puppy at its estimated resting energy requirement (805 kcal [3,368 kJ]/day) with two cans of the new food divided into four meals per day for one to two days; then to feed at
the estimated daily energy requirement (1,600 kcal/day [6,694 kJ]) with four cans of the new food divided into three to four meals
per day for another two days. The owners were instructed to return for a recheck if the puppy did not have a normal stool by the
fourth day. If the puppys stool was normal, the owners were instructed to transition the food back to the original puppy food using
the short schedule outlined in Table 1-1.
Progress Notes
No stool was produced within the first 24 hours of feeding the higher fiber food. By the end of the second day the dog had a normal bowel movement with no blood or mucus. The owners continued to feed the higher fiber food for another two days as instructed. The puppy was then switched back to the dry puppy food over seven days with no problems.
Endnote
a. Hills Pet Nutrition Inc., Topeka, KS, USA.

Small Animal Clinical Nutrition 5th

Uploaded by

Copyright:

Available Formats

Small Animal Clinical Nutrition 5th

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Small Animal Clinical Nutrition 5th

Uploaded by

Copyright:

Available Formats

1

Things should be made as simple as possible, but not simpler.

Similarly, small animal practitioners must improve their

Small Animal Clinical Nutrition

The word recommend means to counsel or advise (American

The Two-Step Iterative Process

repeats itself as a continuous loop and may involve many cycles.

Obtain an Accurate History and

Figure 1-1. The two-step process of veterinary clinical nutrition.

Obtaining the animals history and reviewing the medical

Conduct a Physical Examination

Box 1-1. Malnutrition Includes Excesses.

Conduct Necessary Laboratory Tests and

Small Animal Clinical Nutrition

BCS 1. Very thin

BCS 1. Very thin

Small Animal Clinical Nutrition

creatine kinase concentrations may become a useful marker for

Determine the Key Nutritional Factors and

Key Nutritional Factors

Assess and Select the Food

Determine the Foods Key Nutritional Factor Content

Key Nutritional Factor Comparison

Small Animal Clinical Nutrition

When comparing a patients nutrient requirements to a foods

PATIENTS NUTRIENT NEEDS

FOODS NUTRIENT CONTENT

CONVERTING TO SAME UNITS

*Compare these results with those obtained in Table 2 for moist

and dry foods with the same moisture content.

kcal/g of kJ/g of kcal/g of

% kcal from protein = 0.77 3.33 = 23.1

*Modified Atwater values.

Table 5. Example illustrating the mathematical process required to

Small Animal Clinical Nutrition

2) The next step is to determine the daily energy requirement

better, as owners increase the proportion of new food and

plier that converts the units of the animals requirements to those

Simple Mathematical Ration Balancing

Box 1-3. Four Ways to Determine the Nutrient Content of a Food.

dients can be obtained from NRC nutrient requirement booklets and

Box 1-4. Computerized Food Evaluation/Balancing Programs.

Davis Veterinary Medical

Small Animal Clinical Nutrition

Box 1-5. Food Formulation and

As an example, the Pearson square can be used to solve the

36.0 0.3 = 35.70

The final step converts fraction to percentages by dividing the

having the same concentration as the number in the center

adequacy statement on the products label (Chapter 9).

Physical Evaluation of the Food

Box 1-6. A Method for Calculating the Food Dosage Estimate.

Table 1. Calculation of energy requirements.

Species Crude protein

Key: digest. = digestibility

Small Animal Clinical Nutrition

Table 3. Example calculation of caloric density of a pet food.*

Metabolizable energy (kJ)

3.33 kcal/g (13.89 kJ/g) x amount of food/measuring cup