October 19, 2020 – Dr. Kelly Diehl talks with Dr. Marge Chandler, the clinical nutritionist for Vets Now Referrals in Glasgow, Scotland. They discuss obesity in pets, the latest science about it and what owners can do to keep their pets trim.
00:08 Dr Kelly Diehl: Welcome to Fresh Scoop, Episode 25, new ideas about nutrition and obesity in cats and dogs. I'm your host, Dr. Kelly Diehl, Morris Animal Foundation, Senior Director of Science and Communication. And today we'll be talking with Dr. Marge Chandler. Dr. Chandler is the clinical nutritionist for Vets Now Referrals in Glasgow. Did I say that right, Marge? Glasgow, she's nodding, Scotland, not Glasgow, and internal medicine specialist for Moorview Referrals in Newcastle, England. Marge, welcome and thanks for joining us today.
00:43 Dr Marge Chandler: Thanks very much, Kelly, it's good to see you. And hello and welcome to all the Fresh Scoop listeners with us today.
00:51 DD: So Marge and I did our residencies together, which was just a few years ago. [laughter] But before we get into your work, Marge, can you tell us a little bit about yourself, more personal and your background, and why you decided veterinary medicine, and then specifically, nutrition.
01:13 DC: Why veterinary medicine? I grew up with dogs and cats and horses and cattle and pigs and all sorts of various creatures. I always had an interest in nutrition, which probably means I was kind of a geeky little kid because I can remember reading my mother human nutrition books at quite a young age, so always some interest in that. I got a Master's in animal nutrition after I did my Bachelor's degree and was working various areas and decided that vet school would provide the best way to work in veterinary nutrition. So I actually went into vet school with an interest in that, although by the time I got to... With four years of vet school, I decided I needed to get a break and go into practice for a while. So going back and doing the residencies was a pretty natural step to fulfill my interest in nutrition, and medicine works hand in hand with that really, really well so that's my story.
02:11 DD: Cool. And for folks who are listening, Marge is one of those unusual, what we call double dips, meaning she is boarded in both internal medicine and nutrition, which again, enhances that sort of nutrition background. And there, as you mentioned, there are a lot of nutritional interventions we use with many diseases we see as small animal internists. Moving on from that a little bit, can you give us a little on the history of nutrition and nutritional research for dogs and cats?
02:49 DC: The idea of looking into nutrition for dogs in particular, is really quite old. The first commercial pet food was developed in England, and then the company was moved to the US and then came back to England in the mid-1800s. And the first research... It was a pretty crude diet, actually, the first real research was not research, but maybe interest in looking into the nutrients a bit more was in the late 1800s, so it sort of stuck there for about half a century. The real research got started in the 1960s, animal nutrition was already for large animals, for cows and sheep and other large animals, was already getting well established by then. It took off mostly in the 1970s, and especially feline nutrition took off in the 1970s with a combination of a couple of true geniuses and pioneers in the area. Jim Morris and Quinton Rogers at the University of California Davis started doing phenomenal feline nutrition research and set up labs there to do that, set up PhD programs to do that, which eventually developed also into residency programs. And these two men are actually sort of the academic fathers or grandfathers of many, many, many of the clinical nutritionists who are now boarded, including me.
04:21 DC: My mentor was taught by them at UC Davis, that's sort of where we've gone in a nutshell. We've sort of have the national research council, set up the first nutrient requirements for dogs and cats in the 1980s, that got updated... Kind of a big gap there, in 2006. And then AAFCO (Association of American Feed Control Officials) has also set up nutrient standards for commercial foods in the US, and much of Australasia and FEDIAF (European Pet Food Industry Federation) has set up nutrient standards for all of Europe. So we now have tons and tons of research into all sorts of areas of dog and cat nutrition and lots of ongoing interests on how we can make this better every year.
05:07 DD: Today's... We're going to focus a bit on obesity and we know... Everybody who's listening, knows that obesity is a big problem in people, but can you give us some statistics regarding obesity in dogs and cats?
05:27 DC: In the countries this has been looked at, and this is largely first world countries, Europe, the US, Australia, New Zealand, the studies have ranged at a percentage of overweight and obese dogs and cats from a little over half to two-thirds, depending on which study you look at. The cats seemed to be losing in the bad way on this. They seem to run a little bit higher in percentage of obesity, possibly because we didn't recognize until later how serious a problem this is in cats. They're not cute and cuddly, it's actually a medical problem for them as it is for dogs and people and every other species that becomes overweight.
06:07 DD: Can you tell... I think some people, we probably know that obviously obesity is going to have health effects, but it's... Can you tell us a little bit about the diseases, maybe some surprising ones that are associated with obesity and how obesities, that we know from research, affects lifespan and quality of life?
06:28 DC: Okay, one that's not surprising, that's going to be obvious is osteoarthritis. And I think anybody with an old dog is well aware of the problems with that. I think one of the surprising things about that is a higher percentage of old cats than old dogs actually have arthritis. They mask it more because they spend more time sleeping, and an interesting thing about arthritis that we know from people, it's not just the weight-bearing aspect of it, because overweight people have more arthritis in their hands. So it's actually... Obesity is a disease of inflammation as well, because the lipid fat tissue produces a lot of cytokines that are damaging. So that aspect of it is going to affect a lot of different diseases. So while, arthritis isn't surprising, it's sort of the double whammy you get from the weight-bearing and the inflammation may be unaware for some people. We also have things like lower urinary tract disease and urinary stones in dogs and cats. It's hard to know what's causing what there, but certainly there is a greater prevalence of those in overweight animals.
07:40 DC: The ones that everybody I think is aware of this, the diabetes, type 2 diabetes mellitus in cats where they're at much higher risk for that if they're overweight. Dogs, that doesn't seem to be a risk factor for them, but certainly for cats. There are some types of cancer in pets that seem to occur more in overweight animals. The brachycephalic dog breeds have become very popular apparently... And I don't understand this, apparently during COVID-19 lockdown, people want to get brachycephalic dogs, for some reason. If they become overweight, it's really a disaster for them being able to breathe, and I have even seen an overweight brachycephalic dog die under anesthesia due to his weight problem. And I think there's... The other big two areas for all overweight animals is quality of life, they're less active. There's been one study saying that the animals were more active and appeared happier after they lost weight, and I think any person who's been overweight and lost weight could probably testify to sort of feeling better without carrying around the excess. And we have one study in Labradors showing that those dogs lived longer when they were kept to a lean weight, obviously that would not be an ethical study to repeat, so we only have the one, and it hasn't been looked at in cats. But certainly not being morbidly obese appears to also keep you alive longer, and we know that's true for people and other species, too.
09:09 DD: Knowing that veterinarians are listening, but we also have some laypeople, but I think the definition of obesity and overweight... They're categories. And for everyone, can you clarify what exactly is considered obesity and how you define those categories?
09:31 DC: We'd steal a little bit from human terminology on this, and it's a little bit of semantics or what you want to say, but overweight would be being above the ideal body weight or having more fat than you should have. Obesity is usually stated at being 20% above ideal body weight, I've seen 30% as well. Possibly a better way to judge this is actually the amount of fat and using a body condition score chart, wsava.org website has some good body condition charts that you are free to use and practice and download and hand out to owners if you want. And we would look at anything... We use four to five over nine as an ideal for dog, five over nine as ideal for cats, possibly six over nine for some of the older cats. We are starting to think they might be okay carrying a little bit extra, but that's a little better way of judging fatness. When we talk about controlling obesity, we often talk about losing weight. It's actually fat that we want to lose more than weight. So we've got a couple of ways of looking at this, one is being 20% above your ideal weight, the other would be being a body condition score consistent with overweight or obesity.
10:50 DD: Okay, so I'm going to put Marge on the spot here, which is, how can an owner tell if a dog or cat is obese? Asking for a friend who argues with her husband about their dog.
11:06 DC: Okay, a couple of ways to look at that. Again, the body condition score is a really good one, and what we do, especially... I think dogs are easier than cats for almost everything, and certainly for this as well. You should not be able to see their ribs unless they're like a racing greyhound, which is kind of like a racing thoroughbred, and sometimes you can see the ribs on an animal that's quite lean for doing endurance type work. But for your average at home dog, Labrador-type, spaniel-type dog, you should not be able to see the ribs, you should be able to feel them with a flat hand. So without curling your fingers around or punching them into the dog's side, if your hand is out flat, you should be able to feel the ribs. They should feel like the back of your hand. If they feel like your knuckles... I wish I could demonstrate this, if they feel like your knuckles, they're too thin. If they feel like the fleshy part on the palm of your hand or fatter than that, they're too fat. So you should be able to feel that little kind of... With a little covering over it kind of thump, thump, thump along there. Now, a little covering is okay. When you look at them from the side, they should have a waist, kind of in front of their back legs.
12:24 DC: That part should be tucked up and not level with their chest. Some dog breeds do tend to be a little bit more level, but generally there should be, what we call, a tuck there as you look down on them. They should dent in a little bit behind their ribs, they shouldn't go straight from their ribs to their hip bones and they certainly shouldn't stick out in that area. So that's sort of the... Probably even better than weights or anything, the other things you hear are that they should weigh maybe more or less like they did when they were about a year old, but we are seeing some obese puppies now, so maybe that's not the best way to gauge that.
13:00 DD: So that sounds... And that would hold for all... Those are good guidelines, right? For all body configurations for dogs.
13:07 DC: Pretty much, yeah. Pretty much. Some of the breed associations seem to want those breeds to be chunkier, but that's not consistent with good health. But for dogs, that would be pretty much my standard, for young cats as well, as cats get a little older. I'm a little bit, due to some recent research, willing to let the cats carry just a tiny bit more weight, but it'd be nice to have more research to follow up on that, yeah.
13:33 DD: Right. So if we've... I know it's not easy to help animals lose weight, and what are the thoughts on safe weight loss for dogs and cats? Not crazy crash diets and stuff. What are guidelines?
13:57 DC: Okay. Crash diets are never a good idea for anybody because if you lose weight really fast, you tend to gain it back really fast and then it's harder to lose it the next time, and you tend to lose more lean tissue, lean muscle mass and less fat, and again, it's fat that we want to lose. So guidelines for that. We usually want to start with a good diet history if we are trying to help owners with that and find out everything that's going into the animal's mouth. Sometimes if there's more than one person feeding the animal, that there is little extras being added that they think don't count... I'm kind of smiling. I consulted on a case this morning on one of those where the vet finally had talked to the owner and said, well, she thinks her husband's giving the dog treats in the afternoons. [chuckle] The first two times we discussed this, that didn't come up.
14:47 DC: So just finding out everything they're eating, finding out how many calories are in what they're eating. If they only need to lose a little bit of weight, sometimes you can just adjust the extras, and the treats, and the snacks and sort of figure out an amount of calories to work with what they should get down to, but that's really if they're a six over nine body condition. If they're much over that, that's a hard way to do it. So my recommendation is that they actually go on a program and a lot of the vet technicians are actually running programs like this in a lot of the clinics using a therapeutic weight loss diet. And owners sometimes object to the cost of those, but we've got several studies out now looking at decreasing the amount of a regular adult maintenance diet being fed and you can get into some nutrient deficiencies by doing that.
15:44 DC: If you have to decrease the amount of their regular food too much, they can be deficient in things like calcium, or zinc or protein. So using weight loss diets are actually a really good idea because they have lower calories, lower fat, and increased amounts of some of these other nutrients. Some of them are also formulated to aid in satiety as well so that the dogs and cats don't feel as hungry. So using a weight loss diet, and then calculating the actual calories that are estimating... The calculating, it's an estimation, because it varies so much from animal to animal. What we want them to lose at home for me, is usually around 1% body weight per week. The research studies have gone up to 2%, but that's in a research setting, and it's really hard to do that at home. So for dogs, if they're losing 1% in that range, more or less consistently, I'm pretty happy with that.
16:45 DC: Some people say, "Well, the owners will get frustrated if they don't lose faster," that's not been my experience for cats. If I can get the cats to lose at all over the long term, I'm pretty... Cats are really hard. I'm actually pretty happy with that. My own cat probably took almost a record to get down to the body condition that I wanted him to be in, like a year. [chuckle] So just keeping at it, I think... For vets one of the major things right now, where you might not be able to have them back in the clinic or don't want them back in the clinic too often, is phoning the owners for smaller dogs and cats under 20 kilos, under 45 pounds. The owners can actually buy human baby scales online that are cheaper than pet scales, so they can weigh their pet at home.
17:39 DD: Oh, that sounds... That I think would be really helpful. So it seems like patience... Which they tell us too, right? Losing weight...
17:50 DC: Absolutely, yup.
17:51 DD: It may take a long time and that's good to think about. You mentioned cats, recent research maybe suggesting cats can carry a little bit more weight, and you mentioned how hard it is to get weight off cats, so are there any other differences when you look at obesity in dogs and cats, metabolically or what? Practically, losing weight?
18:17 DC: Yeah, I think we're all now hopefully aware that if a cat is put on too strict a diet, if they're at 60% of their calories or less of what they should be getting is they have an increased risk of hepatic lipidosis. If they don't eat for two or three days, they have increased risk of hepatic lipidosis. So I think that's another reason, one, that cats are hard to get weight off, but that's another reason why I'm pretty careful not to have cats lose way too fast.
18:46 DC: Just as an aside, metabolically, if you do have a cat that goes into type two diabetes, if you can get pretty good control of their diabetes with insulin pretty quickly, so pretty tight control, if the owner... Especially if the owners can take blood at home, and if you can get their body weight or their body fat down to a good degree, that really increases the potential of getting them into remission and off of insulin.
19:15 DD: And which would be a really an excellent thing for people who have to deal with cats and giving injections. So they do pretty well, so I'm going to... Do you...
19:23 DC: I've had to do it with my own cat, so yes.
19:25 DD: Yeah, you're not...
19:26 DC: It is a happy day when you quit giving insulin.
19:29 DD: Right, exactly. So I am... The next question is partly one I wanted to ask, as a person who practiced for a long time, and you've practiced for a long time, and when you talk to, you diet counsel people. And as you mentioned, prescription diets can be pricey, and people ask me about lite, L-I-T-E diets, and they ask about commercial diets, and there's a lot of confusion out there because there's a lot of very heavy advertising that people are bombarded with about diets. So what should owners and vets... Can you talk about commercial lite diets, that aren't prescription, and what owners should be looking at when they read a label and maybe a brief reason why prescription diets might be better for this particular problem?
20:28 DC: I will mention that Alex German at the University of Liverpool did a study looking at the cost of different approaches to weight loss. And he found that using the therapeutic prescription diets was actually cost neutral. It doesn't, in the long run, it did not cost more. And it certainly is cheaper than treating arthritis and treating diabetes mellitus and FLUTD (feline lower urinary tract disorder) and all the dermatological problems and respiratory problems. So there is that part of it. Now lite diets, lite diets have been around forever. Lite diets are generally, and I'm trying to remember if AAFCO is it the same as FEDIAF on this. I'm pretty sure they're both the same or very similar. Lite diets generally are only 10% lower in calories than the company's non-lite version of the same food. So that's actually not very much. That's not enough to lose weight in most cases, without making some other changes, and I think Lisa Freeman and some colleagues looked at the amount of calories in different low calories foods, pet foods, there's a huge variation.
21:38 DC: So in the US, you now have the advantage of the calorie content on the bag. We don't have that in Europe yet, unfortunately. So it's worth having a look at that for owners who maybe are trying to maintain an animal who's lost some weight. There again, there has been a study looking at keeping weight off, which is a huge, huge challenge for people and for pets, once you've lost the weight, to keep it off. And that there was a dog study. The dogs did the best, were kept on the therapeutic weight loss diet at a slightly higher amount. The dogs went back on a maintenance diet, gained the weight back.
22:13 DD: So like yo-yoing like people, I guess.
22:15 DC: Yo-yoing, which is a bad idea metabolically.
22:19 DD: Right. So I am going to ask... Again, asking for a friend [chuckle]
22:27 DC: You have a lot of friends, Kelly.
22:29 DD: I know. I do have a lot of friends and who all have overweight Labradors like me and argue with their husbands. But fiber sources in diets, because I think sometimes there's some bad press about the fiber source...
22:46 DC: Oh, yes.
22:46 DD: And what goes in and it's like remember peanut shells? And so, can you talk a little bit about the different types of fiber and different sources that are used in a lot of these diets?
23:02 DC: Okay, we have hundreds of different fiber sources. So this could be a long topic. Fiber is not a thing. Fiber is a whole bunch of different things, and that's why there's so many different types that potentially could be put into a pet food. They have different attributes on how much they hold water, on how much they are fermented by the bacteria in the gut, on how soluble they are in water, water holding-ness is also sometimes called the gelling amount. And if you take something like Metamucil and add water, this is kind of a fun experiment to do if you have young kids, too. If you take something like Metamucil and add water to it, it turns into sort of a slime mold type thing, you can actually play with. Not that I have ever done that.
23:49 DC: So different attributes of fiber. So what are we looking for in a diet food? Probably one that has a degree of insoluble fiber to it, like cellulose, like the peanut shells and insoluble or non-fermentable fibers. The example I often use for that is like the strings in celery would be sort of a non-fermentable, low-soluble fiber. They're a, kind of do add some bulk to the diet. They're extremely low in calories, kind of like the strings on celery are extremely low on calories. And so they can possibly with dogs, not so much with cats, but with dogs, the added bulk in the diet of a low calorie substance can apparently help with satiety. Their stomachs get full more easily, so they're less hungry. A degree of a fermentable fiber, a partly fermentable fiber like beetroot also seems to have some potential health for the colon because of the short chain fatty acids those are fermented into by the bacteria. So if I am looking for a dog diet that contains fiber source, probably a blend of different ones would be my ideal go to for that. So some that are not fermented that provide a little bit more satiety, some that are fermented that help with the colonic health.
25:17 DC: Cats, not so much. We don't look for as much fiber in a cat diet. Cats are less impressed by eating fiber than dogs. Most of them will, but it doesn't seem to have quite the satiety thing for cats.
25:27 DD: Okay. Well, I'm going to put you on the spot a little bit with that, because remember a few years ago, and I'm not sure what the thought about this is, people were all into Atkins-like diets for cats, right? And you fed them kitten food, and I think people started moving away from that, but what's that kind of tension between a conventional higher-fiber, lower-calorie diet for cats and this whole... The high protein, low carb diets, where are we with research on that for cats?
26:04 DC: Are you talking about for weight loss or for...
26:05 DD: Yeah, for weight loss.
26:05 DC: Any cat or for weight loss?
26:07 DD: Just for weight loss.
26:11 DC: Okay. The degree of added protein for cats and also for dogs, so we do want a weight loss side and the therapeutic weight loss fulfilled this. We do want a slightly higher protein diet for these. It's not really a keto Atkins type diet where you're trying to make them produce ketones. For one thing, it's very hard to make dogs ketouric, because they will metabolize ketones better than people do, a lot better than people do. So as far as a high-protein diet, there is some evidence for protein. Some of it is controversial, yet. There is some evidence that protein will help with satiety. There's some evidence that protein helps with satiety in people. There are some other studies that are less convincing of that attribute. But certainly, protein has better satiety effects than fat. Part of the reason, it's very easy to eat a very high fat meal, as it does not have the satiety effect of protein. There's also studies, first in cats, and then there's been some dog studies, too, that increasing the protein amount does help maintain lean body tissue, which of course is what we want. We want the lean body tissue to stick around and the fat to go away.
27:24 DC: Now, if you get too high a protein diet, and we do get owners that seem to choose a diet based on the protein level alone. Too much protein in a diet basically makes expensive urine because the protein is... everybody, I think listening probably, or most of the people know, is deaminated in the liver. The carbon skeleton is used for energy or for fat, and the nitrogen beyond what the animal can use just goes into the urine. So excessively high protein is just a very expensive way to make a diet and a way to make very expensive pee. So we kind of want to hit the level that the research tells us enhances lean body mass preservation without getting silly and above that. I think, at some point, the research is going to actually tell us which amino acids to choose. There is work in those areas as well, and I think the future at some point will be picking the amino acids that we wish to enhance as well, above and beyond the essential amounts.
28:32 DD: I think that's a common... And maybe you can comment on this a little bit. The diet trends that hit people tend to trickle into animals.
28:43 DC: Absolutely.
28:43 DD: And I've had some questions even at... I don't practice anymore clearly at Morris, but I get questions from people. We get them about keto diets. That seems to be the latest trend, which of course, is in people. So what trends have been particularly... Are particularly dangerous, I guess, in animals?
29:04 DC: In animals? Well, the keto one is just, as I said, kind of silly because you're not going to make a dog ketouric if he's not a diabetic. Probably the one that we have the most question about now is the grain-free diets, and their possible association with dilated cardiomyopathy in dogs. We still don't know the whole story on this so I can't speak too much to it other than there has been an association between some of those diets. There's some certain ingredients, some legumes or pulses... I can't remember what you call pulses in the US. [chuckle] But...
29:43 DD: No, no. Pulses. Pulses works.
29:45 DC: Pulses? Okay. Pulses, that's good. [chuckle] There has been some association between some of the ingredients, legumes and pulses and the dogs who have developed a nutritional dilated cardiomyopathy. Because of that, I don't recommend the grain-free diets, even though we don't understand what's going on with that yet, but there is no benefit to grain-free. Very few animals are actually allergic to the grains in diets. So someday we may know more about that, though we have a very incomplete story with that one yet. Other fads... Natural is always interesting. It's fine, natural diets are fine. Vegan don't have a proven benefit. Organic diets don't have a proven benefit. If people want to feed organic, that's fine. It may enhance sustainability depending on where the products are coming from, but if you're shipping organic coconut oil from the other side of the world, then it doesn't enhance sustainability. So you do need to look at the whole picture if you're doing it for those reasons. I'm trying think what else fads we've had... Probably about the high protein, reading the ingredient list, which doesn't really tell you anything about the quality of your diet necessarily.
30:58 DD: Yeah. No, I was thinking about that, because I think also people are really concerned... Obesity, obviously and health. What do you think are the biggest key factors with getting animals to lose weight? If you had to put a take home message for veterinarians, the vet techs who often write, do a lot of the follow-up, and for owners who are dealing with obesity in their pets, what are some good, consistent guidelines?
31:28 DC: I'm going to change your question just slightly because the most important thing is actually to prevent it. It's so much easier to prevent than to treat. Obesity in people and in pets is frustratingly difficult to treat. The University of Liverpool, where they have quite a good monitored obesity program, followed out some of the dogs that they had successfully lose weight for a couple of years, and 50% of them had put the weight back on, and this is dogs where they're in a good program to begin with, and the owners have been given good education. In people who lose weight, something like 90% of them will gain it back in two years. So we really need to focus on prevention because treatment is so very, very, very hard. So if it's after the fact and you've already got an overweight animal and having lived for quite some time... Like every other cat owner, I have a fat cat and a thin cat, that it's a struggle to do this, to get the weight off them.
32:32 DC: So it's patience, as we talked about, persistent follow-up care with it. So a lot of the owners, just like people with themselves will kind of backslide and go back into habit. So just keep repeating the message, follow up with the owners, don't lose the communication. So I think the big thing we need now, because we know how to lose weight. People, we know how to lose weight ourselves. We know how to get the weight off the animals. You feed the right diet and you feed them less and you don't give them extra food. So the psychology of it will now be where we address this. And looking at when we set up the weight loss program, having the owners tell us where their problems will be. So when we set it up, we need to have them communicate back to us. We need to be asking, "Is this going to work? Where do you see a problem?" Because they'll tell you, if you ask them. If not, they'll just go home and... Like any of us, go home and not follow through. So if they say, "Well, my Aunt Jenny shows up and takes care of the dog on the weekends and feeds him cake. Actually, Suzy's grandmother feeds the dog cake." That's such a common story. Then you need to go into, "Well, how are we going to address this?" So prevention, communication.
33:51 DD: Right. And you were mentioning that you're seeing more obese puppies, why do you think that stuff is happening, they're doing this so early? Like, what do you think is something that you see a common mistake that people could avoid?
34:06 DC: Probably the high calorie extras, and then the pet food company gets blamed for having their feeding guidelines too high. But the feeding guidelines on the bag don't take into consideration all the extra foods they're being fed. They're assuming that's the only food fed. So people will feed what's the guidelines and then give them the piece of cheese and the cookies... People like to give their dogs tea and cookies here, and beer, and don't realize how many calories those are adding on. So I think just an awareness of like a piece of... A good sized piece of cheese, that will be a Labrador's entire treat quota for the day, and it seems like so small for us.
35:01 DD: Right, right. So that's a good point. So maybe also people are training young dogs and they're giving maybe a lot of treats. So that's a good thing to think about that, it's the extras that add up. Even in a young dog.
35:17 DC: Yeah, so we need to get people... And most dogs will eat vegetables, amazingly. And we need to talk to them about using other things as training treats, using lower calorie training treats, especially in dogs that aren't very active. Another one that I've had several people tell me that they're using lately is, I don't know how they keep these in their pocket, but there's blueberries. Blueberries are a very popular dog training treat here.
35:40 DD: So that's good. And berries are, I think good, right? They always talk about berries for people as being particularly good.
35:47 DC: You're not going to eat enough to have that in fat, but...
35:49 DD: Yeah, exactly. Exactly.
35:51 DC: They're good for you, but it's for the resveratrol, you're going to have to eat like kilos of them a day.
35:58 DD: So you mentioned, Marge, the paper for... out of Liverpool. So if you could give that again, and also, are there any other resources for both owners and veterinarians out there that you would recommend people look at? because it's a big, big subject.
36:15 DC: Geez, a lot of groups working on obesity in the US... I know AAHA, I think, has addressed this a little bit. For body condition scores, wsava.org has a lot of information on that, and we are updating on that all the time. We don't have a specific white paper on obesity but we have a lot of other information that's useful on there. Ernie Ward, I know in the US, has, I think that's Pet Obesity Prevention, POP, that he works a lot with. Julie Churchill at the University of Minnesota has worked quite a bit with it. Debbie Linder, Tufts University... Oh, that's a good one. The Tufts University has a nutrition blog, and they run an obesity clinic at that university, and occasionally will touch on obesity in their blog. But it's just a really good nutrition blog, too. So Tufts Cummings University, I can't remember exactly what their login is.
37:17 DD: Yeah, and that blog is really geared toward owners. So it's a good one if you have... For the vets who are listening, if you want to steer people...
37:28 DC: It's geared toward owners, but it's geared toward a perceptive owner. I wouldn't say it's dumbed-down at all, it's well done.
37:35 DD: Right, right. So it's a good place. I also want to put in a commercial for people like Marge, The American College of Veterinary Nutrition, so ACVN has a website. And there are people out there, lots of people that can help do diets and balance diets. I know that for the veterinarians listening, as a person who does GI and would presumably know about nutrition, there were many, many times I had to reach out and get help from nutritionists when I had a patient, especially with any kind of chronic enteropathy that really... and throw in some food allergies and maybe some renal insufficiency, and you need help. You need help balancing their diet. And homemade diets, there are a bunch of resources, and I always felt it was money well spent for the owner because otherwise they're spending it seeing you when their animals aren't doing well. So I would encourage veterinarians listening and owners who are listening, those resources are out there, and you can get personalized help that can really address, when you get to really, really complicated... Again, when you have an animal with multiple comorbidities, it can get quite challenging in treating them. And so that's good. So remind everyone again of that, the Liverpool paper with the cost analysis.
39:00 DC: I don't have the actual reference in front of me, that it would be... Alex German would have been one of the authors. I don't know who else was on that. And I saw this paper just recently, too. I remember running across it within the last week or so but I can't remember how old it is, but they did say that it was cost neutral. It didn't cost actual extra, extra money. I can give you the reference if you can use it later. I can find that for you.
39:25 DD: Yeah, for sure. If we can post it on the website... So everyone who's listening, we'll post it when we post the podcast. So Marge, thanks again for joining us today and telling us about this really complicated but major issue for dogs and cats, and we'll look forward to reading more of your work. Marge writes an awful, awful lot, and she is speaking all over the world about this topic. So thanks for cutting us out of... Cutting, carving time out of your busy schedule. [chuckle] It's good to have friends who do things when you get them to come on your podcast. So again, thanks for joining us, Marge. I appreciate it.
40:01 DC: Yeah, thanks very much, Kelly, and thanks to everybody who's tuned into this for listening to us.
40:06 DD: So everyone, that does it for this episode of Fresh Scoop. And once again, thanks to Dr. Marge Chandler for joining us. And we'll be back with another episode next month that we hope you'll find just as informative. The science of animal health is ever-changing, and veterinarians need cutting edge research information to give their patients the best possible care. And that's why we're here. You can find us on iTunes, Spotify, Google Play Music, and Stitcher. And if you like today's episode, we'd really appreciate it if you could take a moment to rate us because that will help others find our podcast. And of course, to learn more about Morris Animal Foundation's work, go to morrisanimalfoundation.org. There you'll see just how we bridge science and resources to advance the health of the animals. You can also follow us on Facebook, Twitter, and Instagram. I'm Dr. Kelly Diehl, and we'll talk soon.