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 25-28 September, 2018 | Singapore
Step 2: Calculate
Previous weight, BCS and MCS may suggest the ideal body weight for the individual cat. There are several formulae available but a simpler “rule of thumb” is:
• Intact, active cats need 60-80 kcal/kg ideal weight/day
• Sexually altered, less active cats need 40-50 kcal/kg ideal weight/day
• Older cats (> 12 years) need 70 kcal/kg ideal weight/ day.
Using the information regarding what the patient is currently eating, along with physical examination findings, (including hydration), provides a starting point for a nutritional plan. Both the weight loss and muscle wasting need to be addressed.
Caloric requirements should be calculated in order to determine the amount of food required). Ideally, this should be based on a good diet history with known intake as individual calorie requirements can differ greatly from calculated averages. If fed dry food, it should be available at all times, in quiet locations that are readily accessed by this individual. If a cat prefers to eat only a small quantity at a time, moist food may not be appropriate as it is less calorically dense than dry food. While moist food may be preferable in providing more moisture, some cats are reluctant to eat it.
When recommending a change in the diet, recommend that the client monitor closely the amount eaten and make the change gradually over 3 or more weeks. It is not imperative that the cat switches completely to the new food. Within reason, it is more important that they eat adequate amounts rather than what they eat.
EXAMPLE:
4.0 kg cat BCS 3/9, moderate muscle wasting who
previously weighed 4.5 kg BCS 5/9 good muscle mass
At 70 kcal/kg/day, this cat needs 315 kcal/day for 4.5 kg ideal weight.
Protein requirement is at least 5 g/kg ideal weight/day: this cat needs > 23g protein/day
Example using a dry or canned renal diet
Let’s say the dry formulation has 3936 kcal/kg (3.94 kcal/g) or 398kcal/8 oz cup can as fed.
It has 6.61 g protein/100 kcal
For a 4.5 kg cat who needs 315 kcal/day this equals 80g or 4/5th of a cup of this diet/day.
For 315 kcal @ 6.61g protein/100kcal there would be 21 g protein in the day’s dry. This is less than the minimum of 23g/day needed to maintain muscle condition.
For the same diet, the canned has 193 kcal/5.5 oz can, therefore 315 kcal = 1.6 cans
It has 7.23g of protein/100kcal. For 315 kcal @ 7.23g protein/100kcal there would be 23 g protein in the day’s canned food.
It is important that the cat has a good appetite and eats the entire quantity of dry or canned food. With lower calorie intake, protein intake will be deficient. A renal diet has benefits, (i.e. low phosphorus, buffering agents, +/- n-3 fatty acids, etc.), but should the response to the diet reveal inadequate muscle mass, then one needs to supplement the diet with protein or change the diet and use an intestinal phosphate binder, in order to both meet the cat’s nutritional needs while still addressing the CKD.
Step 3: Communicate
Once the ideal body weight has been estimated, either based on historical information or on an educated guess, and the calories needed to maintain this ideal weight
are calculated, it should be noted in the medical record. Regardless of diet chosen, the daily quantity of food (dry and or moist) should be calculated and recorded. The amount of food (grams, cups, cans) that the cat needs to eat must be conveyed to the client both verbally and in writing. Also, make sure that they understand that this is a starting point. For the sake of simplicity, and because the cat and the client may have preferences, the author likes to send home samples of each recommended diet for the cat to try. Once the cat has made their (initial) choice, the quantities can be calculated and given to
the client. Do not try to introduce the new diet in the clinic: a vigilant cat is unlikely to try or like a new diet. Additionally, they may develop a diet aversion.
Step 4: Reassess
It is important to recheck patients 1-2 weeks after
making nutritional recommendations to assess the
effect of the food on the cat’s condition. This is no different than reassessing the impact of other medical recommendations, (e.g., medications, fluids, etc.), or repeating laboratory tests. It is not uncommon that a patient’s decline or lack of improvement is because of feeding factors rather than an inherent progression of their illness. Determine whether the cat is eating enough of the recommended food to result in an improvement
in their weight, BCS and MCS. Find out how the client feels about the diet, feeding the diet, the cat’s enjoyment and QoL on this diet. Providing nutrients may be the most challenging part of any therapeutic regimen, and recovery or attaining the best possible QoL in cats may depend on our ability to ensure optimal nutrition. Again, communication with, and motivation of, the client is crucial.
Step 5: Upping the ante
If body weight, condition and MCS are not improving, additional intervention is required. Verify that the diet appeals to the cat, taking into account its texture, aroma,
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43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS
































































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