Clinical Nutrition Overview & Body Condition Scoring

Assessment & Feeding Plan

Animal

Food

FeedingMethod

Food

FeedingMethod

Clinical Nutrition – An Iterative Process

Step 1: Assess the animal History Physical examination

- Body weight - Body condition score

Laboratory data base Risk factors Key nutritional factors

- Nutrients of concern Energy needs

Clinical Nutrition – An Iterative Process

Step 2: Assess the food(s) Dietary history Visual inspection of food Label evaluation Obtain nutrient profile for

overall diet Compare nutrient intake

versus optimal (KNF)

Step 3: Assess the feeding method

Clinical Nutrition – An Iterative Process

Feeding Route Amount fed How food is offered Access to other food Who feeds the animal

Step 4: Select a food(s) Base food selection on

key nutritional factors

Clinical Nutrition – An Iterative Process

Step 5: Determine a feeding method

Monitor patient response and return to Step 1

Body Condition Scoring

3 - Ideal

Ribs – Easily felt with slight fat cover

Tail Base – Smooth contour with slight

fat coverSide View – Abdominal tuckOverhead view – Well-pronounced

waist

Body Condition Scoring

1 – Very Thin

Ribs – Easily felt with no fat cover

Tail Base – Bones are raised, no fat cover

Side View – Severe abdominal tuck

Overhead view – Accentuated hourglass shape

Body Condition Scoring

2 - Underweight

Ribs – Easily felt with little fat cover

Tail Base – Bones are raised with slight fat cover

Side View – Abdominal tuckOverhead view – Marked

hourglass shape

Body Condition Scoring

4 - Overweight

Ribs – Difficult to feel under moderate

fat coverTail Base – Some thickening bones palpable under

moderate fat cover

Side View – No abdominal tuckOverhead view – Back is slightly

broadened at waist

Body Condition Scoring

5 - Obese

Ribs – Difficult to feel under thick

fat coverTail Base – Thickened and

difficult to feel under thick fat cover

Side View – No waist, fat hangs from abdomen

Overhead view – Back is markedly broadened

Estimation of Ideal Body Weight

BCS % Body Fat (DEXA)

% Ideal Wt.

1 < 5 < 85

2 6-14 86-94

3 15-24 95-106

4 25-34 107-122

5 35-45+ 123-146+Hill’s unpublished

1995

Resting energy requirement (RER)– E used by adult at rest

– Thermoneutral

environment

– Does not support activity,

growth, or reproduction

Food Dosage Determination

RER (kcal/day)

70(BWtkg)0.75

(use for all body weights)

30(BWtkg) + 70*(*when BWt is 2 to 45 kg)

Food Dosage Determination

Daily energy requirement (DER) RER plus calories needed for:

– Temperature regulation

– Digestion & elimination of

nutrients

– Activity

– Lifestage

– Neuter status

Food Dosage Determination

Calculation of Energy Requirements

Feline Maintenance: (0.8 -1.4 x RER)

Neutered adult:= 1.2 x RER

Intact adult: = 1.4 x RER

Obese-prone: = 1.0 x RER

Weight loss: = 0.8 x RER

Weight gain: = 1.2-1.4 x RER at ideal weight

Calculation of Energy Requirements

Canine Maintenance: (1.0 to 1.8 x RER)Neutered adult: = 1.6 x RER Intact adult: = 1.8 x RERObese-prone: = 1.4 x RERWeight loss: = 1.0 x RERWeight gain: = 1.2-1.4 x RER at ideal weight

Canine Work:Light work: = 2 x RERModerate work: = 3 x RERHeavy work: = 4-8 x RER

Nutrient Recommendations - Canine

 Pro

t Fat Fiber Ca P Na Cl K Mg Kcal/g

AAFCO NUTRIENT PROFILES FOR DOG FOODS                    

AAFCO Growth/Repro

22 min

8 min

- 1.0-2.5 0.8-1.6

0.3 min

0.45 min

0.6 min

0.04-0.3

3.5-4.0

AAFCO Maintenance

18 min

5 min

- 0.6-2.5 0.5-1.6

0.06 min

0.09 min

0.6 min

0.04-0.3

3.5-4.0

*expressed as % DMB

Food Recommendations

Nutrient Intake

Reducedintake

Highintake

Deficiency Toxicity

Fu

ncti

on

/perf

orm

an

ce

Minimum requirement

Optimalrange

Nutrient Recommendations - Canine

 Pro

t FatFibe

r Ca P Na Cl K MgKcal/

g

MMI RECOMMENDATIONS                    

Adult Maintenance 15-30

10-20 5 max

0.5-1.0

0.4-0.9

0.2-0.4

0.3-0.6

0.4-0.8

0.04-0.15

3.5-4.5

Growth (Adult BW< 25kg)

22-32

10-25 5 max

0.7-1.7

0.6-1.3

0.3-0.6

0.4-0.8

0.6-0.9

0.04-0.20

3.5-4.5

Growth (Adult BW> 25kg)

20-32

8-12 10 max

0.7-1.2

0.6-1.1

0.3-0.6

0.4-0.8

0.6-0.9

0.04-0.20

3.0-4.0

Older 15-23

7-15 10 max

0.5-1.0

0.25-0.75

0.15-0.35

0.3-0.5

0.4-0.8

0.04-0.15

3.0-4.0

Obese-Prone Adult 15-30

7-12 5-16 0.5-1.0

0.4-0.9

0.2-0.4

0.3-0.6

0.4-0.8

0.04-0.15

3.0-3.5

High Energy 22-34

15 min

5 max

0.6-1.0

0.4-0.9

0.2-0.5

0.3-0.6

0.45-0.9

0.05-0.20

> 4.5

Gestation/Lactation 22-35

10-25 5 max

0.75-1.7

0.6-1.3

0.35-0.6

0.5-0.9

0.6-0.9

0.04-0.20

3.5-5.0

*expressed as % DMB

Nutrient Recommendations - Canine

 Pro

t Fat Fiber Ca P Na Cl K Mg Kcal/g

COMMON COMMERCIAL DOG FOODS                    

Average Moist Grocery (30)

41 27 1.8 1.7 1.4 0.9 1.1 1.1 0.11 4.5

Average Dry Grocery (32)

25 12 3.1 1.4 1.0 0.4 0.7 0.7 0.14 3.9

Average Dry Specialty (93)

28 16 3.3 1.3 1.0 0.4 0.7 0.7 0.12 4.2

Average Moist Specialty (39)

32 22 2.1 1.2 0.9 0.5 0.9 0.9 0.1 4.4

*expressed as % DMB

Nutrient Recommendations - Feline

  Prot Fat Fiber Ca P Na Cl K Mg Kcal/g

AAFCO NUTRIENT PROFILES FOR CAT FOODS                    

AAFCO Growth/Repro 30 min

9 min

- 1.0 min

0.8 min

0.2 min

0.3 min

0.6 min

0.08 min

4.0-4.5

AAFCO Maint 26 min

9 min

- 0.6 min

0.5 min

0.2 min

0.3 min

0.6 min

0.04 min

4.0-4.5

*expressed as % DMB

Nutrient Recommendations - Feline

 Pro

tFat

Fiber

Ca P Na Cl K Mg

Kcal/g

MMI RECOMMENDATIONS                    

Adult Maintenance30-45

10-30 5 max

0.5-

1.00.5-0.8

0.2-0.6

0.3 min

0.6-1.0

0.04-0.1 4.0-5.0

Growth35-50

18-35 5 max

0.8-

1.60.6-1.4

0.3-0.6

0.45 min

0.6-1.2

0.08-0.15 4.0-5.0

Obese-Prone Adult30-45

8-17 5-15

0.5-

1.00.5-0.9

0.2-0.6

0.3 min

0.6-1.0

0.04-0.1 3.3-3.8

Older30-45

10-25

10 max

0.6-

1.00.5-0.7

0.2-0.5

0.3 min

0.6-1.0

0.05-0.1 3.5-4.5

Gestation/Lactation35-50

18-35 5 max

0.5-

1.00.5-0.9

0.2-0.6

0.45 min

0.6-1.2

0.08-0.15 4.0-5.0

*expressed as % DMB

Nutrient Recommendations - Feline

  Prot Fat Fiber Ca P Na Cl K Mg Kcal/g

COMMON COMMERCIAL CAT FOODS                    

Average Moist Grocery (34)

51 27 1.5 1.8 1.5 0.9 1.3 1.1 0.09 4.3

Average Dry Grocery (26)

35 12 2.2 1.3 1.2 0.4 0.8 0.7 0.12 3.8

Average Dry Specialty (42)

35 18.5 2.4 1.1 0.95 0.5 0.7 0.7 0.09 4.3

Average Moist Specialty (35)

46 28 1.9 1.1 1.0 0.5 1.0 0.9 0.1 4.7

*expressed as % DMB

Criteria for normal animals– Complete and balanced for intended

species– Specific-purpose food– Meets optimal nutrient profile range– Nutrients are digestible and

bioavailable– Passed a feeding trial for

appropriate life stage– Marketed by research-oriented,

value-added company– Personal experience with diet

Food Recommendations