Feline Middle Age Spread;Preventing And Managing Obesityin the Ageing Cat
Kelly Eyre RVN
ISFMDipFN and AdvCertFB
Feline Healthy Ageing Clinic Nurse
Georgia Woods-Lee RVN
CertCFVHNut, VTS (Nutrition)
Weight Management Nurse

Image © University of Liverpool, Feline Healthy Aging
ClinicImage © University of Liverpool, Weight Management Clinic

Introduction
Georgia Woods-Lee RVN
CertCFVHNut, VTS (Nutrition)
ROYAL CANIN® Weight Management ClinicNurse• University of Liverpool, Small Animal Teaching
Hospital• Three basic principles• Provide a clinical referral service• Raise awareness• Clinical research
Image © University of Liverpool, Weight Management Clinic

Introduction
Kelly Eyre RVN
ISFM DipFN & AdvCertFB
ROYAL CANIN® Feline Healthy Ageing Clinic
Nurse• University of Liverpool, Institute of Life Course andMedical Sciences•

Study aims to extend the quality of life in our ageingcats through research and education• 6 monthly visits to assess and monitor all aspectsof ageing
Image © University of Liverpool, Feline Healthy Aging Clinic

Introduction

Image © University of Liverpool, Weight Management Clinic

Image © University of Liverpool, Feline Healthy Aging Clinic

Introduction
Ruby

Image © University of Liverpool, Weight Management Clinic

Image © University of Liverpool, Feline Healthy Aging Clinic

Aim:
To improve quality and length of life.

Contents• Age related concerns• Feline obesity care

• Prevalence of age-related disease• Obesity as a disease• Ageing cat consultation• Obesity care programs• Owner feedback• Obesity care for a senior cat

Age Related Concerns

Age Related Concerns
What is ageing?
Ageing is the process of growing old, and healthy ageing is the process ofgrowing older without any age related disease.

What is our aim?
Our aim is to improve the quality and length of their life throughregular monitoring, early detection of disease and the mostappropriate intervention.

Age Related Concerns
Average lifespan14 years oldImages © ICC & ISFM

Prevalence of age related disease
Disease

AgeDiabetes

6-7 years

Osteoarthritis

6-7 years

Chronic Kidney Disease

8-9 years

Hypertension

10 yearsHyperthyroidism

9-10 years

Dental disease

4 years +Obesity
6 years + increase in prevalence

Images © University of Liverpool,
Feline Healthy Aging Clinic

Prevalence of age related disease
209 cats between 7 and 10 years enrolled at the Feline Healthy Ageing Clinic• 3% cats diagnosed with hyperthyroidism• 54% of cats had dental disease• 58% indicated possible musculoskeletal disease• 11% of the cats had potential kidney disease• 4% elevated blood pressure• 57% overweight
Image © University of Liverpool, Feline Healthy AgingClinic

Image © University of Liverpool,
Feline Healthy Aging Clinic

Ageing Cat Consultation• Full physical exam
• Weight, BCS and MCS• Dental exam
• Blood pressure• Cardiac auscultations for heart rate andmurmursImage © ROYAL CANIN®

Image © WSAVA.org

Image © Feline Healthy Ageing Clinic

Ageing Cat Consultation• Goitre check• Orthopaedic exam and watch mobility• Retinal exam
• Abdominal palp
• Blood tests to include biochemistry,
haematology and T4• Urinalysis

Image © University of Liverpool, Feline Healthy Aging Clinic

Image © University of Liverpool, Feline Healthy
Aging Clinic

Ageing Cat Consultation - Frequency• Mature• Annual with vet, 6 monthly nurse• Senior• Annual with vet, 6 monthly nurse dependant
on disease status• Super Senior• Twice yearly with vet, 3 monthly with nurse

Images © ICC & ISFM

Images © ICC & ISFM

Owner Feedback
www.vetprofessionals.com••••

Owner questionnaire
Support diagnosis
Educate owners
Provide before consult

www.catcare4life.org

Owner Feedback – Questionnaire
Breath smells

PhysicalChanges

Feels bony or skinnier

Going outside less

Activity
Changes

Struggling to reach highplacesDifficulty in getting
comfortable

More matted hair

Image © University of Liverpool, Feline Healthy Aging Clinic
Image © University of Liverpool, Feline Healthy Aging Clinic

Owner Feedback – Questionnaire
Dropping food whenchewing

EatingHabits

Leaving more foodbehind in the bowl

Drinking more

DrinkingHabits

Drinking from otherplaces e.g. tap
Difficulty in bending
head to drink

Eating more/lessImage © University of Liverpool, Feline Healthy Aging Clinic
Image © Sonia LorreOwner Feedback – Questionnaire
Aggressive behaviour

Increased urination

Toileting
Changes

Missing the litter tray

Behaviour
ChangesMore vocal
Shrinking theenvironment

Change in faeces

Image © Kelly Eyre

Image © Kim Jones

Feline Obesity Care

Prevalence
39% of cats haveoverweight or obesity*
FHAC (mature cats) 57%

Commonest
form ofmalnutrition

Image © University of Liverpool, Weight Management Clinic

Image © University of Liverpool, Weight
Management Clinic*Courcier E., et al. (2010)

Obesity, A Disease• Chronic, incurable, disease
Positive energy

MER: Maintenance energy requirement
MER after weight loss

*30-50%caloriereduction

Negative energy

Image © University of Liverpool, Weight Management Clinic*German. A J et al (2007)

Obesity, A Disease• Post weight loss
• Lower calorie requirement• Continued obesity care

• Prone to regain“…a disorder of STRUCTURE OR
FUNCTION especially one thatproduces SPECIFIC SYMPTOMS orthat AFFECTS A SPECIFIC LOCATION
and is not simply a result of physicalinjury…”

Treatable, but incurable disease

Image © University of Liverpool, Weight Management Clinic

Obesity, A Disease• Adipose tissue• Adds weight and bulk
• Releases adipokines• Inflammation

Image © Georgia Woods-Lee
Image © University of Liverpool, Weight Management Clinic• Insulin resistance• Affect immunity

Image © Google images

Obesity, A Disease
Associated risk of having obesity
Osteoarthritis*

58% FHAC cats
havemusculoskeletaldisease

Airway disease
Urinary disease*
Metabolic disorders*
Increased cancer risk*
Increased Surgical and anaesthetic risk*
Poor skin and coat** Also an increased risk with aging

Images © University of Liverpool,
Weight Management Clinic

Obesity, A Disease
Reduced quality of life
Reduced life spanImages © University of Liverpool, Weight Management Clinic

Weight loss IMPROVES quality of life

Obesity Care
• Recognition

Calculate the OPTIMAL
weightImage © University of Liverpool, Weight Management Clinic

Image © ROYAL CANIN®

To achieve weight loss
feed for OPTIMAL weightImage © ROYAL CANIN®

Obesity Care Consultations• Gather information• Medical• Dietary• Lifestyle• Environment

Images © University ofLiverpool, Weight
Management Clinic• Examination• Weighing• Body condition scoring• Muscle condition scoring• Measurements• Photos
RECORD allparameters

Obesity Care - Recommendations
Diet

Complete and balanced
Cut out treats and extras
BCS < 6 = Reduce maintenance food
BCS >7 = Use specialist weight management
diets

WeightManagement
diets

Nutrient adjustment for weight loss
Nutrient dense, calorie dilute
Satisfying

Accuracy

Measure food out on digital scales – nomeasuring cups

DivideSplit allocation into 2+ meals a day
Cats will eat 13+ meals per day

Working forfood

Increase meal duration
Increase activity
Allows time to feel fullImages © Georgia Woods-Lee

2 x 2-minuteplay sessions

Obesity Care – Problem Solving• Transitioning
1-2
months ifneeded!
Image © ROYAL CANIN ®

• Treats

Images © Georgia Woods-Lee

Obesity Care – Problem Solving

Video © University of Liverpool, Weight Management Clinic

Increases water intake

Obesity Care – Problem Solving• Food seeking behaviors• Increase meal frequency• Slow down consumption• Unevenly divide food

• Multi-cat households

Images © Georgia Woods-Lee

Obesity Care ForSenior CatsObesity Care For Senior Cats
• Aims• Improve quality of life
• Improve mobility• Not further compromise the patient• Preserve lean body mass

• Holist approach• Consider age• Consider concurrent disease
Image © University of Liverpool, Weight Management Clinic

Obesity Care For Senior Cats
• Weight management in senior cats
• Prevent weight gain
• Safely reduce weight• Correct diet choice• Life stage• Obesity care
• Balanced for the individual needs• Correct amounts• Accurate portioning• Environmental modifications
Image © University of Liverpool, Weight Management Clinic

Obesity Care Balanced For Senior Cats• The Obesity Paradox*• Older age, when associated withconcurrent progressive disease• Diabetes• Renal disease• Heart failure• Cancer• The importance of tailored plan
• 6% weight loss
= Noticeable physical benefit

High adipose tissue mass = bettersurvival
Image © University of Liverpool, Weight Management Clinic*Slupe, (2008)

Obesity Care Balanced For Senior Cats
Tailored plans• Reduce weight >6%• Reduce weight by 15 to < 20% - NOMORE• Dependent on health status• Lean tissue loss observed >20% ofweight loss*
Image © University of Liverpool, Weight Management Clinic* German (2016)

Obesity Care Balanced For Senior Cats
• 80% of cases at the Weight Management
Clinic have concurrent disease• Tailored for the individual• Disease dependent• Improve quality of life

Images © University of Liverpool, WeightManagement Clinic

Obesity Care For Senior Cats - Environmental Modification
Reduced mobility due to aging andobesity can cause anxiety so owners may
see a reduced amount of time spentoutdoors

Litter tray
• Number of trays• Correct size
• Low sided• Correct substrate• Increase hygiene• Location

Image © Kelly Eyre
Image © Google

Image © Kelly EyreObesity Care For Senior Cats - Environmental Modification• Increase fluid intake• Add water to wet food
• Correct water bowls• Water fountains• Increase number• FelaquaImage © Sure Petcare, Felaqua
Image © Chloe Little

Image © Google

Obesity Care For Senior Cats - Environmental Modification• Access to favourite places• Cat flap access• Horizontal scratch posts• Increase grooming• Obesity• Dental disease• OA• Raised food and water bowls• Low impact play

Images and video © University of Liverpool, Feline
Healthy Ageing Clinic

Obesity Care For Senior Cats - Ruby
Ruby

Image © University of Liverpool, Feline Healthy Aging Clinic

Image © University of Liverpool, Weight Management Clinic

Aim:
To improve quality and lengthof life.

Obesity Care For Senior Cats - Ruby
• Weight
9 years old at enrolment
Start weight: 7.3kg
BCS 9/9

Chronic Renal
DiseaseIRIS Stage 2• Body condition score• Morphometric measurement

Optimal weight: 3.5kg• Photographs

Target weight: 5.8kg• Blood pressure

Weight reduction: 1.5kg• Biochemistry and hematology

Total weight loss (%): 20%
Images © University ofLiverpool, WeightManagement Clinic• Urinalysis• DEXA scan

• Weight management planObesity Care For Senior Cats - Ruby
Feline Healthy Ageing Clinic detected:• Chronic kidney disease• Musculoskeletal disease in spine, rightshoulder and elbow• Dental disease – FORL’s• Obesity – 9/9
Image © University of Liverpool, Feline Healthy Aging Clinic• Hyperthyroidism – Dx post weight lossHighlights theImportance ofmodest weight loss

Obesity Care For Senior Cats - Ruby
Advice given:• Regular monitoring• Environmental modification for OA• Supplements for OA• Dental under GA• Increase water intake to support kidneys• Treatment for hyperthyroid

Summary• Age related concerns• Feline obesity care

• Prevalence of age-related disease• Obesity as a disease• Ageing cat consultation• Obesity care programs• Owner feedback• Obesity care for a senior cat

Aim:
To improve quality and lengthof life.

Thank you for listening

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Feline Healthy AgeingClinic

Image © University of Liverpool, Weight ManagementClinic

Image © University of Liverpool, Feline Healthy Ageing Clinic