VNJ Volume 38 (3) June 2023 | Page 34

ABSTRACT There is a lack of primary research on veterinary nurse-led clinics , yet 80.3 % of veterinary nurses carry out nurse-led clinics in practice [ 1 ] . Canine obesity is a prevalent condition , with between 25 % and 59 % of pet dogs in the UK considered to be overweight or obese [ 2 – 5 ] .
This article outlines the veterinary nurse-led approaches to canine obesity management and reviews current primary literature in the areas of nurse-led clinics and canine obesity . It also makes recommendations for future practice in relation to nurse-led clinics , based on current evidence .
A literature search was conducted , using several keywords / terms , inclusion / exclusion criteria and a variety of databases . Seven pieces of primary research were chosen , as they were deemed appropriate and they met all the criteria . These seven pieces of research were analysed , discussed and explored to create a literature review exploring the efficacy of veterinary nurse-led clinics in managing canine obesity .
The results indicated that health-related quality of life is reduced in overweight and obese dogs but improves after successful weight loss [ 6 ] . For managing weight loss in overweight dogs , dietary calorific restriction is more effective than increasing physical activity [ 7 ] . Finally , nurse-led clinics in areas of human medicine such as atrial fibrillation and gout have proved efficacious , and this could be transferred to the veterinary field .
The author concludes that canine obesity can be managed via veterinary nurse-led clinics , as many veterinary nurses already offer these in practice . There should be an emphasis on calorific restrictions instead of increasing activity levels , as the studies reviewed show this is more effective . This weight loss will improve health-related quality of life , leading to happier , healthier dogs .
Keywords canine obesity , quality of life , veterinary , nurse-led , clinics , efficacy
Introduction
Obesity is a condition in which excess body fat has developed to the point that health is adversely affected [ 8 ] . It can also be known as a chronic disease in which adipose tissue accumulates in a way that affects the health of the patient [ 9 ] . Canine patients are generally regarded as clinically obese when their body weight is at least a certain percentage over ideal . Gossellin et al . [ 10 ] state that this is 15 % above ideal , whereas Becvarova [ 11 ] state it is 20 % above ideal .
Canine obesity is the most common nutritional health problem in dogs [ 12 , 13 ] . There is a high prevalence of canine obesity in Western countries [ 14 ] , with between 25 % and 59 % of pet dogs in the UK considered overweight or obese [ 2 – 5 ] . After an owner survey , the People ' s Dispensary for Sick Animals ( PDSA ) stated in 2021 that 14 % of dog owners reported their pet to be overweight , and 9 % of dog owners reported their pet to have gained weight since March 2020 [ 15 ] . Obesity is known to predispose to or exacerbate a range of medical conditions , including diabetes mellitus , bladder cancer , mammary cancer [ 16 ] , respiratory distress , hypertension , cardiac disease , dystocia , decreased heat tolerance , dermatological problems [ 10 ] and osteoarthritis [ 17 ] .
The relationship between canine diabetes and obesity is a subject of discussion in the veterinary profession . Pöppl et al . [ 18 ] state that no study has demonstrated how obesity can cause diabetes in dogs . Catchpole et al . [ 19 ] state that , although obesity clearly influences the animal ' s ability to utilise glucose , progression to overt diabetes has yet to be documented . However , there is evidence that the rise in canine obesity in the past decade has led to a rise in canine diabetes of a similar magnitude [ 20 ] . Glucose intolerance associated with obesity might contribute to insulin resistance , but it is not considered a primary cause of diabetes in dogs according to Catchpole et al . [ 19 ] .
There is a gap in the literature on the relationship between canine obesity and diabetes , so it is appropriate to examine the relationship between human obesity and diabetes . Human obesity is a major health hazard and plays a central role in the pathogenesis and aetiology of diabetes [ 21 ] . In addition , a significant predisposition to insulin resistance is observed with human obesity [ 22 ] . Body mass index also has a strong relationship to diabetes and insulin resistance [ 23 ] . In an obese individual , the amount of non-esterified fatty acids , glycerol , hormones , cytokines , pro-inflammatory substances and other substances that are involved in the development of insulin resistance are increased [ 23 ] .
Obesity can affect the clinical course of mammary gland tumours in female dogs [ 24 ] . The results of a 2021 study by Lim et al . [ 25 ] suggest that obesity may influence canine mammary cancer development and progression , being associated with higher histological grade , greater infiltration of tumour-associated macrophages and increased tumour angiogenesis . However , a 2007 study by Weeth et al . [ 26 ] found it difficult to reach direct conclusions regarding cancer cachexia or obesity as a risk factor in the development of cancer in dogs .
Current research suggests that obesity in humans is a risk factor for the development of hand osteoarthritis and both the development and progression of knee osteoarthritis . There is solid evidence to support weight loss as an effective treatment for knee osteoarthritis . The exact mechanism of the relationship between obesity and osteoarthritis is not completely understood , but it is likely to involve both biomechanical and biochemical factors [ 27 ] .
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