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Promoting Preventive Nutrition NURSE KNOW-HOW / PEER REVIEWED T Nutrition plays an essential role in veterinary medicine Promoting and is recognized as the 5th vital assessment. A Preventive Nutrition nutrition evaluation and recommendation should be performed for every Shoshana Verton-Shaw, RVT, VTS (Nutrition) patient at every Muirkirk, Ontario, Canada appointment.1 54 veterinaryteambrief.com April 2016 TEACHING TARGET PREVENTIVE NUTRITION SHOULD BE INTEGRATED INTO PREVENTIVE WELLNESS PLANS TO MEET LIFESTAGE, LIFESTYLE, AND NUTRIENT REQUIREMENTS, HELP AVOID DISEASES, AND HELP ENSURE PATIENT HEALTH FOR AS LONG AS POSSIBLE. he goal of preventive ! Medical history: Previous condi- nutrition is to maintain a tions or injuries may indicate a Diet Calculations patient’s health as long as potential concern possible by integrating ! Breed: Consider common nutrition into preventive breed-related predispositions Step 1: Calculate resting energy wellness plans. Wellness ! Environment requirement (RER) = 70 x (ideal body weight in kg)0.75 diets meet the patient’s ! Gender current lifestage, lifestyle, Step 2: Calculate daily resting ! Body and muscle condition and energy requirements = RER x and nutrient requirements weight: Small changes can indicate Lifestage factor while helping avoid other diseases. a trend toward malnutrition T (eg, obesity) Lifestage However, wellness diets following the ! Nutrition history: Feeding method Factors7,8: lifestage nutrition concept are often and patient preferences may dictate underused, despite projected growth potential limitations. in pet food sales showing that most Dogs: clients recognize the importance of Build Client Compliance ! Neutered adult = 1.6 nutrition and are willing to pay a Preventive nutrition involves client ! Intact adult = 1.8 premium price for their pet’s food.2,3 education about certain nutrients’ ! Obese prone = 1.2-1.4 A 2003 AAHA compliance study roles in disease prevention. Without ! Weight loss = 0.8-1.0 found that 90% of clients want a clear communication and understand- ! Growth nutrition recommendation from the ing, clients may not see the benefits, • <4 months = 3.0 veterinary team, yet only 15% and compliance may decrease. In • >4 months to adult = 2.0 4 reported receiving one. most families, pets are considered Cats: 6 essential members of the family. To ! Neutered adult = 1.2 To best plan and promote preven- maximize client compliance, focus on ! Intact adult = 1.4 tive nutrition, the veterinary team customization. Unlike grocery and ! Obese prone = 1.0 should start by developing a pet supply stores, which offer ! Growth = 2.5 potential problem list rather than a life-sustaining foods that appeal to current list. The team can then trends, sometimes in specialized match key nutrition factors in veterinary wellness diets to address and minimize the patient’s poten- Therapeutic vs Preventive Nutrition tial problems.5 Patient Assessment Therapeutic nutrition treats or manages disease, whereas preventive nutrition addresses environmental or genetic risk factors to prevent or minimize Veterinary nurses take a leading role disease. in providing preventive nutrition, The veterinarian formulates a therapeutic nutrition plan by creating a beginning before the patient is problem list and matching the diet with the appropriate key nutrition presented and continuing through factors to address each condition as part of a complete treatment plan. file review. While obtaining the To increase client compliance with a therapeutic diet, the veterinary team patient’s history, the veterinary should clearly communicate the diet’s benefits. Caloric intake and output are nurse should perform a nutrition key discussion points. assessment, which should include: April 2016 Veterinary Team Brief 55 NURSE KNOW-HOW / PEER REVIEWED Ask clients what is most important about their pet’s nutrition and what drives their food purchases, which will help clients make informed choices. flavors, shapes, and sizes, the veteri- provide an opportunity to educate References 1. Nutritional Assessment Guidelines. WSAVA nary team provides individual clients about the correct tools and Global Nutrition Council. http://www.wsava. nutritional recommendations based resources and help them make an org/sites/default/files/JSAP%20WSAVA%20 Global%20Nutritional%20Assessment%20 on a thorough understanding of informed choice for their pet. Guidelines%202011_0.pdf. Accessed January species- and breed-specific needs as 2016. 2. Byrne JA. Spending on pet food grew to record well as the needs of each patient. Further improve compliance with in 2012. New York Post. http://nypost.com/2013/ 04/21/spending-on-pet-food-grew-to-record- Ask clients what is most important the team’s recommendation by in-2012. Published April 2013. Accessed January about their pet’s nutrition and what providing a nutrition prescription 2016. 3. Phillips-Donaldson D. Global update: Premium drives their food purchases. Often that briefly conveys the relevance of petfood sales projected to continue growth their decisions are based on misinfor- the diet’s features for the patient and through 2019. Adventures in Petfood. http:// www.petfoodindustry.com/blogs/7- mation driven by powerful market- client. Include a specific diet and adventures-in-pet-food/post/5008-global- ing campaigns or on trends in the exact feeding amount based on a update-premium-petfood-sales-projected-to- continue-growth-through-2019. Published human nutrition. These discussions diet calculation. Simply listing the December 2014. Accessed January 2016. range on the side of the bag does 4. The Path to High-Quality Care: Practical Tips for Improving Compliance. Lakewood, CO: AAHA not provide any additional services Press; 2003. Resources 5. Hand M, Thacher CD, Remillard RL, Roudebush to the client and may contribute to P, Novotny BJ, eds. Small Animal Clinical overfeeding and obesity. Ask the Nutrition. 5th ed. Topeka, KS: Mark Morris veterinarian to provide his or her Institute; 2010:4-9. ! AAHA’s Nutritional 6. Coren S. Do we treat dogs the same way as signature to further highlight the children in our modern families? Psychology Assessment Guidelines. Today. https://www.psychologytoday.com/blog/ American Animal Hospital importance of the proposed nutri- canine-corner/201105/do-we-treat-dogs-the- Association. https://www. tion plan. n same-way-children-in-our-modern-families. aaha.org/professional/ Published May 2011. Accessed January 2016. resources/nutritional_ assessment.aspx. TEAM ! WSAVA Global Nutrition TAKEAWAYS: Guidelines. World Small Animal Veterinary Veterinarians: Formulate for clients a nutrition prescription that includes Association. http://www. a specific diet and exact feeding amount and conveys the diet’s relevance wsava.org/guidelines/ for the patient and client. global-nutrition-guide- lines. Management Team: One study found that 90% of clients wanted a nutrition recommendation from the veterinary team but only 15% received one,4 so ! WSAVA Global Nutrition management should ensure all team members know the importance of Toolkit. WSAVA Global communicating preventive nutrition to every client. Nutrition Committee. http://www.wsava.org/ Nursing Team: Veterinary nurses play a leading role in providing nutrition-toolkit. preventive nutrition. Before the patient presents to the practice, veterinary nurses should review the patient file, then obtain a complete ! Nutritional Tools & history and perform a nutrition assessment during the examination. Resources for Veterinary Healthcare Teams. Pet Client Care Team: Help the rest of the veterinary team build client Nutrition Alliance. http:// compliance by understanding and clearly communicating the role and petnutritionalliance.org. benefits of preventive nutrition in disease prevention. 56 veterinaryteambrief.com April 2016.
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