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What’s New in the Old?:
Feeding Older Pets
D. P. Laflamme,
DVM, PhD, DACVN
Nestlé Purina PetCare Company
Pets are Living
Longer
Improved nutrition
– Balanced diets
Improved health care
– Preventative health care, vaccination & dental care
– Better diagnosis & treatment of dz
Changes in management systems
– Confinement → trauma + infectious dz
Effect of Age on Disease Prevalence
0
5
10
15
20
25
30
'6-7 '8-9 '10-11 '12-13 '>13
CRF
0
5
10
15
20
25
'6-7 '8-9 '10-11 '12-13 '>13
GI disease
Dogs Cats
0
2
4
6
8
10
'6-7 '8-9 '10-11 '12-13 '>130
10
20
30
40
50
'6-7 '8-9 '10-11 '12-13 '>13
CancerDiabetes
(Kraft 1998)
Effect of Pet Age on
Owner-Perceived Health Status
Age % Cats Dogs
H G U H G U
< 7 60% 92% 7% <0.5% 95% 5% <0.5%
7-11 29% 69% 28% 2% 71% 28% 1%
12-15 9% 58% 42% 0 52% 46% 2%
>15 3% 52% 35% 13% 33% 33% 33%
Total number = 1101
(Laflamme et al, 2008)
Nutritional Evaluation
Animal Factors
– Signalment and medical history
– Physiologic status & environment
– Body weight & Body condition score
– Physical examination & laboratory
evaluation
– Recent changes
Age Group (Years)
Appro
xim
ate
% O
verw
eig
ht
0
10
20
30
40
50
10-12 12-15 15+0-5 5-7 7-10
Cats Dogs
(from: Armstrong & Lund 1996)
Geriatric Nutrition:
Percent of Overweight Patients
Senior Pet
Evaluation
Change in body weight/ condition
»PERCENT change in weight
0.5kg change in 4kg cat is comparable
to ~ 9kg change in 70 kg person
Age Group (Years)
Appro
xim
ate
% U
nderw
eig
ht
0
10
20
30
40
50
10-12 12-15 15+0-5 5-7 7-10
Cats
Dogs
(from: Armstrong & Lund 1996)
Geriatric Nutrition:
Percent of Underweight Patients
Body Weight in last 4 yrs. prior to death
3000
3200
3400
3600
3800
4000
4200
4400
4600
4800
5000
012345678910111213141516
Quarter prior to death
BW
(g
)
Cancer Predicted Cancer Other Predicted OtherRenal Predicted Renal Thyroid Predicted Thyroid
(n=258)
(Perez-Camargo 2004)
Preventing weight loss
may aid survival Anecdotal reports, esp. CKD cats
Research: 90 cat longevity study:
– All cats lost weight over time
– Longest surviving group lost least
Maintaining
weight, BCS, LBM,
fat mass increased
odds for survival
(p < 0.001)
(Cupp et al 2006; 2008)
Effect of Age on MER of Adult Cats
Age (years)
2 4 6 8 10 12 14 16 18
ME
R (
Kcal/kg
bo
dy
weig
ht)
20
40
60
80
100 MatureAdult Geriatric
(Laflamme 2005)
Daily Energy Intake in Cats (Kcal/kg bwt)
Aged 10 to 15 yr
TKC/KG v. AGE
AGE
TK
C/K
G
48
52
56
60
64
68
72
76
10 11 12 13 14 15
(Cupp 2003)
n = 85
0
2
4
6
8
10
12
14
16
18
20
1 to 7 8 to 10 10 to 12 12 to 14 >14
Years of age
Incidence of Reduced Protein Digestibility
in Cats by Age%
In
cid
en
ce
(Perez-Camargo 2004)
Incidence of Reduced Fat Digestibility*
0
5
10
15
20
25
30
35
1 to 7 8 to 10 10 to 12 12 to 14 >14
years
* Low Fat Digestibility: < 80%
0
5
10
15
20
25
30
35
40
12 to 14 >14 years
Wet
Food
Dry
Food
(Perez-Camargo 2004)
Implications of Compromised
Digestive Capacity
Negative energy balanced and weight loss
Deficiency/depletion of fat soluble (EFA,
Vitamins A, D, E) & water soluble nutrients
(B- Vitamins, trace minerals)
Negative nitrogen balance, loss of LBM, reduced
protein turnover, decreased immune function
Changes in Lean Tissue (g) of Cats with
Age (n=256)
1000
1500
2000
2500
3000
3500
grams
1 to 3 3 to 5 5 to 7 7 to 9 9 to 11 11 to
13
13 to
15
15 to
17
17 to
20
Years
(Perez-Camargo 2004)
Age alters Gene Expression in
Canine Skeletal Muscle
Geriatric dogs had decreased expression of genes
related to:
– Energy metabolism, including electron
transport & TCA cycle
– Protein biosynthesis & ribosomal function
– Cell cycle/turnover, cell proliferation & cell
differentiation
– Immune functions and oxidative stress response
Metabolic changes in aged muscle contribute to
reduced strength & function
(from Middelbos et al 2009)
Muscle Mass Score
Systems
Score Muscle Mass
0 On palpation over the spine, scapulae, skull, or wings of
the ilia, muscle mass is severely wasted
1 On palpation over the spine, scapulae, skull, or wings of
the ilia, muscle mass is moderately wasted
2 On palpation over the spine, scapulae, skull, or wings of
the ilia, muscle mass is mildly wasted
3 On palpation over the spine, scapulae, skull, or wings of
the ilia, muscle mass is normal
(Michel et al 2011; Buffington et al 2004)
Nutritional
Evaluation
Dietary Factors
– Normal diet
» Commercial pet foods, by brands
» Treats, snacks and other foods
» Nutritional supplements
– Nutritional content
– Nutritional adequacy for patient
Survey about OTC Senior K9 DietsAAFCO
MIN
“Adult
diet”Senior Diets (n = 37)
Kcal/cup 433 336 (246 – 408) cup
365 (312 – 411) can
g or mg/ 100 Kcal
Protein 5.1 5.9 6.9 (4.8 – 13.1)
Fat 1.4 3.4 3.4 (2.4 – 6.3)
Crude fiber 0.4 0.9 (0.2 – 2.9)
Sodium 20 105 89 (33 – 412)
Phosphorus 140 243 264 (134 – 412)
(from Hutchinson et al 2011)
Geriatric Nutrition: Calorie Requirements
Generally decreased across species due to
lower activity and lean body mass
Daily energy needs decrease in DOGS by
20 – 25% from young adults to seniors
Daily energy needs decrease in CATS by
~20% from young adults to middle age, but
then increase.
Geriatric Nutrition: Protein Requirements
Decreased efficiency in digestion and/or
metabolism leads to increased requirement
with age
Actual estimate of “minimum requirement”
differs based on methods used
Effect of Method and Age
on Minimum Protein
Needs in DogsYoung dogs Old dogs
*Grams protein/kg body weight
Min. Requirement* 0.9 1.25
Nitrogen Balance
Optimal Protein Turnover* 2.5 3.75
Protein:DNA Ratio
(Wannemacher J Nutr 1966)
88
90
92
94
96
98
100
LB
M,
% o
f in
itia
l
Initial 1 yr. 2 yr.
17% protein
46% protein
Kealy, 1998
Effect of Dietary Protein on Lean
Body Mass in Aging Pointers
Balanced Nutrition for Seniors
An increased nutrient to calorie ratio is needed
to maintain essential nutrient intake when
calorie intake is lower
Carbohydrate
Non-essential fat
Essential Fat
Minerals
Vitamins
Protein
Normal Inactive Obese
Tot
al int
ake
SOME senior foods
are reduced in protein
Geriatric Nutrition: Protein Needs
Older cats should receive at least 34% of
calories as protein
Older dogs should receive at least 20 - 25%
calories as protein
% FAT 6-10% 11-15% 16-20% 20-22%
Percent Protein
Cat >30-33 >34-36 >36-38 >40-44
Dog >20-25 >22-28 >24-30 >26-33
Protein, as % of dry diet
Nutritional Evaluation
Feeding Management
– Amount and frequency
fed
– Shared food bowls
– Diet acceptance
– Recent changes
Reasons for decreased intake in
“healthy” aging dogs & cats
Change in diet
– Lower calorie
– Lower palatability
– Different
Reduced access to food
– Competition
– Location
Loss of senses: smell, taste, appetite
Some Common Diet Related
Problems in Aging Pets
FEEDING INDUCED
Obesity
DIET SENSITIVE
Osteoarthritis*
Renal disease
Cognitive Dysfunction*
Diabetes Mellitus
LTB4
AA
PGH2
5-LOX
COX
TXA2PGE2
Promotes and/or stimulates:
Neutrophil chemotaxis
Inflammation
Promotes and/or stimulates:
TNF IL-1 MMPs
Inflammation & Pain
NSAIDs
Role of Arachidonic Acid
•COX produces PGE2 and TXA2
•Stimulate TNF-, IL-1, and
MMPs
•LOX produces LTB4
•Neutrophil chemotaxis
LTB5
EPA
PGH3
5-LOX
COX
Weak neutrophil
chemotaxis
TXA3PGE3
Decreased stimulation of
TNF IL-1 MMPs
n-3n-6
Update on Diets for Canine OA
Clinical studies published in 2010 – 2012 show
improvement in:
– Client assessment of lameness, ability to rise, walk,
play, etc.
– Force plate analysis of weight bearing
~1.0 % – 1.5% EPA + DHA “effective” for OA
– (Hansen 2008; Moreau 2012 )
Other supplements – MAY be beneficial but
evidence is poor (Vandeweerd et al. 2012)
Is all Omega-3 fatty
acid the same?
ALA (C18:n-3) has only ~ 7% the efficiency to raise
EPA levels vs preformed EPA (Aterburn 2006)
(Bauer 2007 )
Omega-6:Omega-3
ratios are not
meaningful!
Adipokines
17HSD
AdipsinAngiotensinogen
VEGF
PAI-1
Leptin
100+
Resistin
Adiponetin
RBP4Lipocalin 2
WNT5aIL-18
IL-6
IL-1
RAS /ACE
proteins
MCP-1
Amyloid A
Complement 3 TNF-CRP
ANGPTL2
Incidence of CHD (OFA) in Ad libitum and
Limit Fed Dogs at Two years of Age
(Kealy et al 1993)
20
15
10
5
Severe
Moderate
Mild
Borderline
Control Lean-fed
Lean body condition delayed need for
medication for osteoarthritis
Control Restricted
Age @
treatment
10.3* 13.3
+ 3 years!
* P < 0.01
Effects of Weight Loss in Dogs with OA:
Enhanced ability to:
Jump into car/truck or onto furniture
Sit down and rise from a sitting or lying down
position
Walk up or down stairs
Less stiffness in the morning or evening
Less pain when walking/turning
Posturing to urinate/defecate appeared easier
Increased voluntary activity
= enhanced quality of life
Canine Cognitive Dysfunction:
Can diet help?Behaviours affected Orientation
Social interaction
Housetraining
Sleep wake cycle
Owners of Senior dogs report the their dogs. . . forget things and are less interested in their environment
and family activities
can be resistant to changes in their life and dislike novel
new things
can lose focus when playing or become distracted
Antioxidants & Brain function Aged canine & human brain shows mitochondrial
energy dysfunction and increased free radicals with
oxidative stress
Brain benefits from dietary antioxidants:
– Reduced oxidative stress
– Reduced amyloid proteins (precursor & betaA)
– Enhanced mitochondrial respiration
– Reduced neuron loss & Improved cognitive function
All effects greatest with combination of
antioxidants and mental enrichment
(Pop 2010; Snigdha 2011)
Energy Metabolism
in the Brain
• Glucose
• Predominant energy source
• Use by brain decreases dramatically with age,
particularly in the memory and learning region
• Lactate:
• Produced by astrocytes via glycolysis
• Produced during exercise
• Increased use by brain during exercise
• Ketone bodies: produced by astrocytes or liver
- Beta-hydroxybutyrate (BHB); Acetoacetate
Alternate Energy Sources to
Preserve Brain Function
Ketones feed the TCA cycle to overcome brain
hypometabolism
MCTs provide alternate energy source and source of
ketones
Studies in humans & dogs show improved cognitive
function with MCT supplementation
MCTs increase β-hydroxybutyrate
in Senior Dogs
0
20
40
60
80
100
120
140
160
Day 0 Day 120 Day 240
Ser
um
BH
B (
um
ol/
L)
Control
MCT
* p<0.05
*
*
(Pan et al 2010)
Study Results• Dogs fed MCT diet had significant improvements
– Attention span & Spatial memory
– Trainability
– Executive function (decision making; switch strategies)
– Concept learning capacity
– Overall cognitive function
• Other studies showed MCT supplementation:– Improved mitochondrial energy metabolism
– Decreased β-Amyloid precursor proteins
– Decreased oxidative damage
– Increased n-3 PUFA in parietal cortex
(Studzinski 2008; Taha 2009; Pan et al 2010)
Canine Cognitive Dysfunction:
Can diet help?Behaviours affected
Orientation
Social interaction
Housetraining
Sleep wake cycle
Beneficial targets:
• Antioxidants
• Alternative energy sources (e.g. MCTs)
• Weight management
• Exercise
• Mental Stimulation
SUMMARY
Especially for senior pets, it is important to
complete a thorough nutritional evaluation.
• Diet and amount tailored to
need of individual pet
• Energy needs can change with
age
• Protein requirements increase
with age
• Senior pets more susceptible to
chronic diseases which may
benefit from diet