Dechra Brand Guidelines

Diet Information Sheet

og RecommendedSPECIFIC TM diet

Rationale

SPECIFIC TM diets for nutritional support of hypothyroid dogs *

CXD -S, -M, -XL,CXW Adult

Completemaintenancediets, tailored to age andbreed-size, as anutritional aid for supportof health in adultor seniordogs. TheseSPECIFIC TM maintenancedietshave a moderateenergy density formaintenanceof idealbodyweight, fattyacids fromfish formaintenanceofhealthy joints, skin and coat and added beta-glucans for supportof the immune response. The controlledcontentofproteinandmoderately reduced contentofphosphorusand sodium inSPECIFIC TM Senior reduce theworkloadof the kidneys and support renal function in senior dogs.With increased levelsof taurineandL-carnitine to support cardiac function in seniordogs.

Nutritional management as an adjunct to medical treatment of hypothyroid dogs

Conditionof thedog RecommendedSPECIFIC TM diet

Rationale

CRD-1/CRW-1 Weight Reduction

A high-protein, low-fat,high-fibrediet with a reducedenergy density for successfulweight reduction. The highprotein level and L-carnitine supportmaintenance ofmusclemass.

Overweightor obese

Intakeofomega-3 fatty acids andbeta-glucans can alter theproductionof eicosanoids and cytokines and support the immune response 4 . Thyroidhormones have adirectpositive inotropic and chronotropic effecton the heart.Although it is not sure ifhypothyroidismwill cause clinical cardiacdisease, existing cardiac failure canworsen in hypothyroiddogs 5 .Nutritional support fordogs with reduced cardiac function isbasedon restriction of sodium intake, supplyof sufficient taurine and L-carnitine andhigh intakeofomega-3 fatty acids. In studies indogswith cardiacproblems, intakeof fish oilwas associatedwith increased life expectancy 6 , reduced incidenceof arrhythmias 7 and reduced cachexia 8 . Hypothyroiddogs canhave a combinationofmultiple endocrinedisorders. In a studybyDixon et al . ten per centof thehypothyroiddogs also haddiabetes mellitus 9 .Although these endocrinedisorders require medical treatment, nutritionalmanagement can help to support someof the complications (poor bloodglucose control, hyperlipidaemia,poor skin condition and recurrent infections)which commonly accompany endocrinedisorders. Successful treatmentwith levothyroxine is associatedwith an increase inphysical activitywhich mayunmaskor intensifyotherproblems such as osteoarthritis. Adietwith increased levelsofomega-3 fatty acids andglucosamine and chondroitin can support healthy joints andmobility 10 . Dependingon thepresenceof concurrent complications and the conditionof thehypothyroid dog, appropriatedietary advice shouldbegiven. It is recommended to continuemonitoring the nutritional statusof thedog andpresenceofpotential concurrent complications and to adapt the nutritional management for each individualdog as needed.

Hypothyroidism requiresmedical intervention through thyroid hormone supplementation.However, some complicationsof thediseasemaybenefit from supportivemeasures such asnutritional management.Nutritional assessment is an important aspectofoptimalpatient care, sinceoptimal nutrition can enhancebothqualityof life and life expectancy. It is therefore recommended to includenutritional assessment as the5th vital sign in the standard physical examinationof eachpet 1 .Fordogs diagnosed andmedically treated forhypothyroidism, anutritional assessment shouldbe includedduring routinemonitoringof thedog.Basedon theoutcome of thenutritional assessment – including assessment of thedog’s age,body condition score,muscle condition score andpresenceof concurrent clinical conditions asdermatologicalproblems,overweight, cardiac failure andpoormobility – a recommendation foroptimal nutritional support shouldbemade for each individualhypothyroiddog. Hypothyroiddogshave a reducedbasalmetabolic rate,whichputs them at riskofbecomingoverweight orobese.Successful treatmentwith levothyroxine will result in some reductionofbodyweight,but indogswithmore severeweightgain additional nutritionalmanagement is recommended.Restricted feedingwith a high-protein, low-energydiet has proven tobe effective to achieve effectivebody weight loss,whilemaintainingmusclemass 2 . Most hypothyroiddogspresentwithdermatological abnormalities such as scaling, alopecia and recurrent skin infections. Restorationof thepoor skin condition inhypothyroiddogs requires sufficient supplyof skin-supportive nutrients.Adietwith increased levelsof fatty acids and essential skin- supportivenutrients such as vitaminA,E andB complex,protein, zinc and selenium can support restorationof compromised skin andmaintenanceof both ahealthy skin and coat 3 .

The recovery can happen in weeks. The positives can last a lifetime.

or CGD -S, -M, -XL,CGW Senior

CED Endocrine Support

The increased levelof skin-supportivenutrients (fatty acids, vitaminA,E, andB complex,protein, zinc and selenium) supports the highdemand for skin-related nutrients for restorationofpoor skin and coat condition. The high concentrationof omega-3 fattyacids,EPAandDHA , and added beta-glucans can alter theproductionof eicosanoids and cytokines and support the immune response. CEDEndocrineSupport has a moderateenergydensity and an increasedfibrecontent formaintenanceof idealbodyweight and is speciallydesigned to support themanagementof endocrinedisorders. The increased levelof skin-supportivenutrients (fatty acids, vitaminA,E, andB complex,protein, zinc and selenium) supports the highdemand for skin-related nutrients for restorationofpoor skin and coat condition. The high concentrationof omega-3 fattyacids,EPAandDHA and added beta-glucans can alter theproductionof eicosanoids and cytokines and support the immune response. CΩDOmegaPlusSupporthas a highenergydensity and is specially designed for supportofdermatologicalproblems and conditions responsive tohigh intakeofomega-3 fatty acids. The moderate sodium level helps tobreak the vicious cycleofwater retention.High levelsof omega-3 fattyacids,EPAandDHA , can help to supportmaintenanceofmusclemass, appetite and cardiac rhythm.Thediet supplies sufficientenergyandprotein to support maintenanceofbodyweight andmusclemass.With added L-carnitine and taurine for supportof cardiac function. CEDEndocrine is speciallydesigned toprovide additional dietary support for complicationswhich commonly accompany endocrinedisorders. A highfibre level and a lowglycemic index support controlof the bloodglucose level. Uniquelyhigh levelsofomega-3 fattyacids can help increase insuline sensitivity, regulate hyperlipidemia and togetherwith added betaglucans support the immune system. Increased levelsof skin-supportivenutrients support restoration ofpoor skin and coat condition.

Poor skin and coat condition, recurrent skin infections

lmanagementof the individualdog shouldbebasedonnutritional assessmentof thedog, taking into account thedog’s n score,muscle condition score andpresenceof concurrent clinical conditions. It is recommended that thenutritional eatedon a regularbasis and thatdietary recommendations are adapted accordingly, ifnecessary. ent cardiac failurewith concomitant kidney failureSPECIFIC TM CKD/CKWHeart&KidneySupport is recommended. a reduced sodium level,omega-3 fatty acids,L-carnitine and taurine for supportof cardiac function and also restricted rus andprotein to reduce clinical signs andprogressionof kidney failure.

CΩD OmegaPlus Support

alAssessmentGuidelines Task ForceMembers (2011)WSAVANutritionalAssessmentGuidelines. AnimalPractice 52 : 385-396. M (2004)High-protein low-carbohydratediets enhanceweight loss indogs. ion 134 :2087S-2089S. Nutrition and skindiseases in veterinarymedicine. ClinicalDermatology 28 : 686-693. Effects ofbeta-glucan extracted fromSaccharomyces cerevisiaeon growthperformance, and immunological ic responses ofpigs challengedwithEscheria coli lipopolysaccharide. JournalofAnimalScience 84 : 2374-2381. ielRE (2012)Canine hypothyroidism. InBSAVAManualofCanine and FelineEndocrinology.4th edn. andMEPeterson.BritishSmallAnimalVeterinaryAssociation.pp 63-85. l. (1998)Nutritional alterations and the effect of fishoil supplementation indogswith heart failure. nary InternalMedicine 12 : 440-448. 007)Omega-3 fatty acids inBoxerdogswith arrhythmogenic right ventricular cardiomyopathy. nary InternalMedicine 21 : 265-273. l. (1998)Nutritional alterations and the effect of fishoil supplementation indogswith heart failure. nary InternalMedicine 12 : 440-448. 1999)Epidemiological, clinical, haematological andbiochemical characteristicsof canine hypothyroidism. d 145 :481-487. 2010)Multicenter veterinarypractice assessment of the effectsofomega-3 fatty acids inosteoarthritis indogs. ericanVeterinaryMedicalAssociation 236 :59-66.

CΩD OmegaPlus Support

Concurrent cardiac failure **

CED Endocrine Support

Concurrent endocrinedisorders (diabetesmellitus, hyperadrenocortism)

CJD Joint Support

Poormobility

A completediet fordogs for supportof a healthy joint function. The uniquely high levelsofomega-3 fattyacids,EPA andDHA , and added naturalglucosamineandchondroitin support healthy joints andmobility.The moderateenergydensity supports optimalbodyweight and therebymaintenanceof healthy joints.

thyroncontainsLevothyroxinesodium ProductsA/S,Mekuvej9,7171Uldum,Denmark. ductsA/S isa tradingbusinessofDechraPharmaceuticalsPLC. /hyperadrenocorticism

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January2014