The Biggest Loser

As a feline veterinarian, you know your next appointment is going to be, different, when you look out the hospital window and see two women struggling with a large carrier. That actually happened to me about a year ago as I waited for a new patient to arrive.

I was at the front desk when a car pulled up and the women got out. They were obviously prepared for what happened next, as one of the one got a ramp out of the trunk. The ramp was placed against the opened back seat and the crate was gently slid to the ground. The two women then took their places – one at the front; the other at the back and proceed to pull and push the crate along the short walk to the front door.

Before dashing out to help, I looked at the appointment calendar. There was a new patient listed and the client concern (the reason he was being brought in) was listed as “not using the cat box.” A third hand (mine) didn’t make the job easier, but we eventually got the orange tabby behemoth into the clinic and into the closest exam room. The carrier top was opened, the sides undone and the carrier “deconstructed” around the patient.

He was truly the largest, fattest cat I had ever seen. He completely filled the exam table top. At the time, we used a scale that had been used in a human hospital nursey to weigh infants and he barely fit in the trough. His weight? A very, very hefty 31 pounds.

The clients were, of course, somewhat embarrassed. They admitted that his weight had crept up over the years but the tipping point was when they had to have carpeting replaced that had been soiled by the kitty using the hallway as a cat box. He was unable to lift his heft into any box, so simply gave up.

The appointment was a long one. I saved the medical concerns that we think about in fat cats: Diabetes, orthopedic problems, etc. for mid-way in the conversation. I was more interested in whether or not they were committed to help the kitty lose weight. They were.

When normal labwork arrived the next day, we embarked on a safe weight loss plan for our kitty, with no real goal in mind, although I thought that we should aim for a “fighting weight” of 18 pounds. We calculated the amount of food that was necessary for safe weight loss, thought about ways that exercise could be added to his day and began a weight loss plan that wasn’t unlike some of our more popular television shows.

It’s often tough to think about ways to get these large cats to move. We started slowly: Food was (of course) his greatest love and we went to meal feeding a canned, low carbohydrate diet. He would get breakfast and dinner and no treats in between. Before feeding, the clients would walk through the house with the dish, forcing him to move. As the weight came off, we added the basement stairs to the routine.

Normally, I have clients purchase a baby scale to take weekly weights of the patients at home – and report them back to me. No baby scale was found to be large enough to accurately weigh him (most only go up to 25 pounds), so until we reached that point, the clients came in every two weeks for a weight check and progress report. If any of you have attended weight loss group meetings, the same elation with the weight loss and disappointment when the needle didn’t move downward was experienced.

After a year, our goal weight was in sight and our patient was a new kitty. While still heavier than most cats, he was using the cat box (which thrilled the clients), had an interest in life and seemed to be a happier cat. Undoubtedly, he felt better and was happier.

For many cat companions, having a portly cat is a matter of some pride. After all, in our culture, who doesn’t want to be a “fat cat”? But feline obesity has skyrocketed as it has in humans and the toll is considerable in our kitties: Diabetes, musculoskeletal problems and pain, the inability to groom normally, skin infections, etc.

Weight loss in cats is tricky, in that what we don’t want is a rapid weight loss. The liver of cats can’t handle being inundated by fat breakdown products and sudden, dramatic weight loss – whether done by conscious weight loss program or by illness and inappetance – an result in an often deadly condition called fatty liver disease. These cats present very ill and commonly require the placement of a temporary feeding tube to get them well.

Cat clients definitely should be as savvy about the content of the foods they are feeding as they are about the number of calories that they themselves take in during the day. It is often helpful to calculate the RER, the resting energy requirement, that gives a good estimate of the number of calories a kitty needs each day to perform body functions. To calculate the RER for a particular cat, take their weight in pounds and divided by 2.2 – that gives us the kilograms. Multiple kilograms by 30 and add 70. As an example, an 11-pound cat (5 kilos) will need about 220 kcals a day to maintain his weight. Of course, inactivity (or, conversely lots of exercise), genetic factors, etc. all can affect the number. Some cats need fewer calories to maintain normal weight; others more.

Weight loss programs should only be done under the guidance of your cat’s veterinarian. There are prescription diets available, but at the recent American College of Veterinary Medicine meeting, it was shown that the number of calories consumed and not the type of food actually made the greatest difference. For cat health, veterinarians are now regularly recommending the feeding of a low-carb canned diet (these typically mimic the natural diet of cats). Janet and Binky’s List (available online) has a list of scores of canned diets, along with their carb content (aim to feed one with less than seven percent carbs) and the calorie content of each.

If your kitty is waddling, don’t give up. It’s slow work to lose weight, but the rewards of a healthier, happier cat are well worth it.