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An Urban Experience
• Heartworm/flea prevention from vet
• Temp: 101.1 F
• Wt: 8.18kg Previous Wt: 10.0 kg
• BCS: 5/9
• MCS: 4/4
• Cardio/Pulmonary: normal
• Pain 0
Nutritional Assessment:
• Diet factors: AAFCO diet...good
• Patient factors: Normal
• Environmental/Mgmt Factors: appears appropriate
Risk Factors: Nothing identified Extended Assessment: Not needed Treatments:
• Routine puppy vaccines and exams
Routine exams, no risks factors, you are done! Barriers to Implementation
As in any change in practice protocol, there are potentially many reasons a necessary and valid idea fails to be initiated. Effecting change necessitates a team approach with near total “buy-in” that this change will result in better medicine, improve efficiency, provide professional growth and is actually doable. Taking the time to educate the entire team will improve confidence and acceptance. The template used above in an actual busy general practice validates the feasibility of incorporating nutritional assessments into everyday exams.
Other than the practice team, potential other barriers may be client perceptions that the clinic is just trying
to market their own brand of nutrition for profit, time management, disinterest, and of course, the confusing information available on the internet from “experts”. Use of neutral, unbranded materials, such as the 19 tools provided in the WSAVA Toolkit, nutrition-toolkit, can greatly assist the busy practitioner.
• Lack of knowledge by the practice team and client • Lack of confidence
• Lack of acceptance by practice team
• Perceived time commitments
• Client perceptions • Internet information
1. JSAP, July 2011;52(7):385-96
2. JAAHA, July/August 2010, Vol. 46 3. VetClNA, July 2014, 44.4: 644-66
Incorporating nutritional assessment into our standard exam protocol has helped this team feel they are practicing best medicine. A side benefit was the increased pride and teamwork that developed. How often could an illness have been more easily diagnosed if a more complete picture of the patient’s health and environment had been provided? Knowing that a new food was introduced, or that the BCS has changed dramatically could be the factors that trigger a more extensive assessment and diagnostic workup, thus hopefully earlier detection on an underlying issue, both nutritional or metabolic.
Of course, any new program should be continuously reviewed and updated, based on user feedback.
The WSAVA Global Nutrition Committee Toolkit Website is available for free downloads of their materials for the practitioner, and are available in English, Chinese, and Spanish.
Example Case: Copper Presentation History:
• 3-month-old M Vizsla
• Diet: tested under AAFCO feeding trials brand
• Treats: Vitamins from the Veterinary hospital
• Feeding Frequency: 3X/day
• In for vaccines and exam

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