Nutritional factors to consider for aging patients

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In her lecture “Furever Young: Optimizing Nutrition For Aging Dogs and Cats,” presented at the Fetch dvm360 Conference in Atlantic City, New Jersey, from October 14-16, 2024, Danielle Conway, DVM, CVA, VSMT, CCRP, addressed the need for effective nutritional support in aging pets. She highlighted the importance tailoring nutritional recommendations to address the unique needs of older pets, including considerations for their physical and metabolic health

“Unfortunately, our patients are just never seeing the nutrition support that they need,” said Conway during her lecture.¹

She began by explaining normal aging changes in older pets that influence nutrition, which include degenerative and metabolic changes. Conway explained that ongoing conditions relating to microbiome shifts, sarcopenia, and age-related diseases should be factored in when deciding what nutritional recommendations should be given to clients.

In her session, Conway explained that all older patients are chronologically old, meaning that number-wise, they have a higher age. However, chronologically old patients can also fall within 3 categories of geriatric:

• Physically young: Chronologically old patients that are eating an adult diet well, their lab work appears to be excellent, etc.
• Metabolically efficient: Chronologically old patients that are overweight/easy keepers that may not need to be fed at their resting energy requirement (RER) or be receiving life stage factor.
• Metabolically inefficient: The true geriatric patient that is conventionally taught in veterinary school and has an identifiable physical or metabolic disease.

Recommendations for veterinarians

Making diet recommendations to owners of older pets can be challenging due to the rise in misinformation surrounding pet food,² incomplete diet histories, and lack of food brands.¹

A good nutrition plan, according to Conway, factors in the owner’s needs and wants. It is important to constantly reassess patients’ diet and have conversations with clients about their pet’s diets, explained Conway.

Conway recommends telling clients to take a picture of their pet’s bag of food prior to their appointment. She explained that adding the request in the text reminders for clients’ appointments can help avoid confusion over what foods clients are feeding their pets.

“Some of the practices I work with, I build them a questionnaire based on…[the] information that they need, that they would want, to make quick recommendations. [I] build it into a form that the clients fill in, either ahead of time and bring it into their appointment, or that they can fill out at their meetings, so that [veterinarians] have all the information that [they] need to make a specific recommendation, or to even be able to assess the current diet that [the patient is] on,” expressed Conway.

For veterinarians recommending senior diets for aging pets, Conway emphasized the importance of asking the pet food company or having the client ask the company what that company’s definition of ‘senior’ is, as the term can be ambiguous and have no set definition. “Sometimes [‘senior' means] higher protein, sometimes it's lower protein, sometimes it's higher protein phosphorus, sometimes it's high protein and high phosphorus, and sometimes it's high fat, sometimes it's low fat, sometimes it's fiber, sometimes it's no fiber,” explained Conway.

Challenges in nutrition for healthy geriatric patients

Factors to consider when creating a nutrition plan for older patients include these animals’ changes in degenerative and metabolic functions, which can lead to increased or decreased energy requirements in dog and cats—in felines, the energy requirements generally increase, whereas in dogs they tend to decrease. Moreover, digestibility is reduced in senior patients, as well as their microbiome diversity.¹

It is important to also maintain lean body mass in geriatric patients. “Some seniors get more hungry and they tend to gain weight due to a lot of factors and others don't want to eat, and we should be using more calorically dense diet to help them maintain their body weight,” said Conway. “So, we want to look for a really high caloric diet that is… palatable to help keep these seniors maintaining a good, healthy body and muscle condition score.”

Increasing palatability

Towards the end of her session, Conway explained that food toppers are a great way to increase palatability in geriatric patients that are struggling to maintain their weight. Products like honey, bonito flakes for cats, FortiFlora probiotic powder, and bone and vegetable broth can be added to patients’ meals. However, Conway emphasized that these toppers should account for less than 10% of the patient’s RER if they are not complete and balanced.

References

1. Conway D. Furever Young: Optimizing Nutrition For Aging Dogs and Cats. Presented at: Fetch Coastal; October 14-16, 2024; Atlantic City, NJ.
2. Bautista-Alejandre A. Navigating pet nutrition and talking diets with clients. dvm360. October 14, 2024. Accessed October 22, 2024. https://www.dvm360.com/view/navigating-pet-nutrition-and-talking-pet-diets-with-clients