Today we're going to talk about big issue - did you know that your chubby pet can have big problems? According to the WHO, obesity in humans has tripled since 1975 [1] and considering that pets are now considered family members they are also affected by their guardians' lifestyles.
Obesity is the most prevalent disease in dogs and cats [8], and it is estimated that between 34% and 63% of the world's dogs and cats are obese [5]. Although it is known that obesity negatively influences our pet’s health, well-being and longevity [8] and that being overweight reduces pets' life expectancy by up to 2.5 years [4], it is still not widely recognized as a health problem by many owners and veterinarians.
But how do you know if your pet is obese?
Dogs and cats are considered obese when their weight exceeds the ideal by 15-20%. It is now known that obesity has various causes, ranging from genetic to environmental factors. Although some endocrine diseases, drugs and rare genetic disorders can contribute to obesity, it usually occurs when there is a positive energy balance, i.e. when when calorie intake exceeds expenditure [4].
With regard to genetic predisposition, there is a higher frequency of overweight/obesity in some dog breeds such as the Labrador, Cavalier King Charles Spaniel, Shetland Shepherd, Cocker Spaniel, Rottweiler, Yorkshire Terrier and Poodle. Among cats, it has been observed that domestic short-haired and long-haired cats, mixed-breed cats and Manx cats are also more prone to obesity [4].
In addition to genetics, there are other factors that predispose dogs to obesity, such as the amount of daily exercise and the volume of food eaten. Spayed females are also more prone to obesity, since there is a reduction in estrogen levels, which, among its functions, also plays a role in controlling food intake and energy expenditure. For this reason, it is very important to readjust the diet after castration. In cats, predisposing factors include feeding frequency, age over 7 years and neutered males [4].
And why is excess weight so harmful?
In the past, it was believed that fat was just a metabolically inert energy store used during prolonged fasting. In addition, it was known that excessive fat accumulation led to overweight, joint problems, cardiac overload and reduced respiratory capacity[5]. Today, it is known that adipose tissue is complex and active and secretes a series of cytokines, inflammatory mediators and hormones that act on the body [4].
Among the substances secreted by adipocytes, which are the cells of adipose tissue, is leptin, a hormone known for suppressing appetite and increasing energy expenditure, as well as other substances called adipokines that also have local and systemic effects [4,5]. Although leptin is an anti-obesity hormone and obese individuals have high levels of circulating leptin, they can be resistant to it. Leptin also suppresses apoptosis, stimulates mitosis (which could explain the higher incidence of cancer in obese people), regulates immune and reproductive functions, modulates insulin sensitivity, exerts pro-inflammatory and pro-thrombotic effects, plays a role in angiogenesis (the creation of new blood vessels) and inhibits adiponectin, which is an adipokine synthesized and secreted by mature adipocytes that contributes to an increase in insulin sensitivity and a decrease in serum glucose concentrations. Serum concentrations of adiponectin are decreased in obese dogs and cats, probably as a result of the inhibition caused by the secretion of inflammatory cytokines. In addition to adipose tissue, the gastrointestinal and reproductive systems also influence obesity through the hormones they secrete[4].
And what are the consequences of obesity?
The problems associated with overweight can be metabolic and/or mechanical. The former can cause local, peripheral and central effects. The latter occur as a result of increased body mass and weight on the bones, joints, cardiovascular system, etc. They are usually slow and progressive and often the owner seeks veterinary help when the conditions have already become chronic or are at an advanced stage [4].
Osteoarthritis, which was the subject of our November article, is one of these problems. This is due to the inflammatory action of leptin, which along with an increase in other cytokines and inflammatory mediators can degrade cartilage. In addition, the continuous action of overweight on the joints contributes to the development of osteoarthritis over time [4,5].
Obesity is also a risk factor for the development of various respiratory diseases, as it reduces lung compliance and total thoracic capacity. Excess abdominal and thoracic fat increases intra-abdominal pressure and affects respiratory function. There is mainly a reduction in the volume of exhaled air, reducing airflow [2, 4].
Another link between obesity and metabolic and hemodynamic disorders is the increase in circulatory volume and vascular resistance, which contribute to hypertension. Abdominal obesity is associated with heart disease in dogs due to worsened cardiac relaxation and reduced left ventricular systolic function, and is associated with portal vein thrombosis and myocardial hypoxia [4].
Furthermore, serum concentrations of cholesterol and triglycerides are often increased in obese individuals, which can lead to dyslipidemia. Obese dogs and cats with insulin resistance have lower lipoprotein activity and reduced lipolysis. In addition, high levels of cholesterol have been associated with eye damage, while high levels of triglycerides have been associated with acute pancreatitis in dogs [4,5].
There is also the problem of diabetes mellitus, since insulin resistance associated with obesity is one of the predisposing factors for type 2 diabetes mellitus, especially in cats. Studies show that overweight cats are almost 4 times more likely to develop this type of diabetes [4,5].
Also, obese animals produce less serotonin and low serotonin levels reduce colon transit time, predisposing to constipation, which is common in obese cats. Additionally, a slower gastrointestinal transit time can lead to greater food fermentation, changing the intestinal microbiota [5] and causing imbalances. It is now known that the gut and its microbiota are closely linked to the immune system, and their imbalance can promote autoimmune and inflammatory disorders [3].
And we mustn't forget that hormones and growth factors produced by adipose tissue, cytokines and central mechanisms that regulate energy balance can contribute to the development of cancer. Insulin and other hormones such as IGF-1 (insulin-like growth hormone1) play an important role in the development of cancer, meaning that calorie restriction contributes to inhibiting carcinogenesis [4].
The good news is that we have the option of addressing this problem with a relatively simple, safe and natural treatment. But of course we can't do without a reduction in calorie intake accompanied by an increase in calorie expenditure [2].
The holistic treatment of obesity begins with an individualized approach, since there are individual metabolic variations that must be taken into account, as well as possible emotional disturbances that can influence excessive calorie intake. First, the degree of overweight or obesity is assessed by combining body weight with the Body Condition Score (BCS) [4]. A calorie reduction strategy is then outlined along with the other complementary treatments.
As for homeopathic treatment, there is no specific drug to treat overweight and obesity. Instead, we look for the medicine that most closely resembles the patient's characteristics, which is very useful in terms of rebalancing the body, making the patient more active, more relaxed and less anxious and depressed, which can be linked to the condition. The same applies to Bach Flower therapy - the assessment of the patient's behavior, characteristics and emotions will define the best combination to assist in treatment.
Regarding nutraceuticals and phytotherapics, there are some options that act as adjuncts in treatment and I have successfully applied it in clinical practice.
The first and best known for its thermogenic activity is ginger (Zingiber officinale). Epidemiological and clinical studies show that ginger and its main constituents exert beneficial effects against obesity and other related disorders, such as diabetes and cardiovascular disease. Its effects are mediated by the regulation of lipid metabolism, suppression of carbohydrate digestion, modulation of insulin secretion and response, inhibition of oxidative stress and increased anti-inflammatory activities, as well as anti-hyperlipidemic, hypotensive and anti-atherosclerotic mechanisms [10, 11].
Modulipet®, a natural product composed of tryptophan and glutamic acid from beets, is also very useful. It acts to re-establish neuroendocrine communication between white adipose tissue and the nervous system by normalizing the production of neuronal growth factors, improving the breakdown of fats (lipolysis) and aiding the weight loss process, as well as having a neuroprotective and antioxidant effect.
Recently, oleoylethanolamide (OEA), a monounsaturated fatty acid derived from oleic acid, has reached the market. It is known for being a PPARa agonist, which is a peroxisome proliferator receptor that plays an important role in the differentiation of adipocytes and in glucose and lipid metabolism. The endogenous synthesis of OEA occurs mainly in the intestine and its concentration in this organ is associated with the level of satiety. Although it is an analog of anandamide, it has no direct action on CB1 and CB2 cannabinoid receptors, exerting its effects mainly through stimulation of the afferent branches of the vagus nerve in the gastrointestinal tract, establishing communication of the gut-brain axis and promoting regulation of energy balance, fatty acid catabolism and lipogenesis [9].
Despite all these tools, we stress that the tutor is the key to successful treatment. According to studies, 40-50% of the guardians of pets with BCS>5 did not consider their animals to be overweight. It is therefore very important that owners understand their crucial role in changing eating habits, reducing snacks and treats and increasing the frequency and duration of walks, rides and playing [4].
Likewise, it is important for the veterinarian to understand that there may be limitations on the part of pet owners, such as the fact that many use treats as a way of showing affection to their pet. Snacks may be allowed, but they should be reduced to a maximum of 10% of the total daily calories ingested. Thus, in the treatment of overweight and obesity, the success depends on establishing a relationship of trust and commitment between pet guardian and veterinarian, with a focus on the pet's health!
REFERENCES
2) GARCÍA-GUASCH, L. et al. Pulmonary function in obese vs non-obese cats. Journal of Feline Medicine and Surgery, Vol. 17(6) 494–499, 2015.
3) LAZAR, V. et al. Aspects of Gut Microbiota and Immune System Interactions in Infectious Diseases, Immunopathology, and Cancer. Frontiers in Immunology. V. 9. Article 1830. 2018.
4) RAMOS-PLÁ, J.J. Obesity, In: ETTINGER S. J., FELDMAN, E. C. Textbook of Veterinary Internal Medicine, 8 ed., Saunders, 2017, cap. 176.
5) WEETH, L. P. Other Risks/Possible Benefits of Obesity. Vet Clin Small Anim 46 (2016) 843–853.
6) ZHANG, A. et. al. Association of atopic dermatitis with being overweight and obese: A systematic review and metaanalysis. J Am Acad Dermatol. V. 72, N. 4. 2015.
7) BOULET, L. p. Obesity and Atopy. Clinical & Experimental Allergy, 45, 75–86, 2014.
8) KIPPERMANN, B.S., GERMAN, A.J. The Responsibility of Veterinarians to Address Companion Animal Obesity. Animals, v. 8, n. 143; 2018. doi:10.3390/ani8080143
9) Ivashkevich, D. et al. Effect of Oleoylethanolamide-Based Dietary Supplement on Systemic Inflammation in the Development of Alimentary-Induced Obesity in Mice. Nutrients 2023, 15, 4345.
10) WANG, G. et a. Beneficial effects of ginger in metabolic syndrome. Ann. N.Y. Acad. Sci. (2017) 1–16 C_ 2017 New York Academy of Sciences
11) Attari, V.E. et al. A systematic review of the anti‐obesity and weight lowering effect of ginger (Zingiber officinale Roscoe) and its mechanisms of action. Phytotherapy Research. 2018;32:577–585.
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