Animal Endocrine Clinic March 18 Seminar

We are pleased to announce our second Animal Endocrine Clinic Seminar:

Animal Endocrinology:

Perils and Pitfalls in the Diagnosis and Treatment of Endocrine Diseases 

This seminar will take place on March 18th in Westchester County, NY. AEC Seminars are free and are open to veterinarians and veterinary technicians. The March 18th seminar will deal with several of the most common canine and feline endocrine disorders.

Dr. Mark E. Peterson and Dr. Rhett Nichols will discuss Hyper- and Hypothyroidism, Thyroid and Parathyroid Tumors, Primary Hyperparathyroidism, Idiopathic Hypercalcemia, Diabetes mellitus, Cushing's syndrome, and Hyperaldosteronism.

Further details and the registration form are available here.

Paper Review: Dietary Sugars Intake and Cardiovascular Health. A Scientific Statement From the American Heart Association

High intakes of dietary sugars in conjunction with the current worldwide pandemic of obesity, hypertension, and cardiovascular disease have heightened concerns about the adverse effects of excessive consumption of sugars in humans. Between 1970 and 2005, average annual availability of sugars consumed increased by 19%, which added 76 calories to Americans’ average daily energy intake.

Excessive consumption of sugars has been linked with several metabolic abnormalities and adverse health conditions, including obesity, hypertension, and cardiovascular disease. In addition, high sugar intake may lead to the development of the metabolic syndrome, as well as increased inflammation and oxidative stress. Finally, excessive sugar intake is associated with shortfalls of essential nutrients.

In view of these considerations, the American Heart Association has published a position paper on this subject, which recommends reductions in the intake of added sugars. Click the following link to read the full paper, which was published in the journal Circulation and is available online (1). It brings home and important message that we need all heed.

My Comments:

Important Role of the Glucose-Insulin Response to Chronic Disease 
Many factors influence the body’s glucose response to foods, including the composition of the food (fat, protein, sugar, starch, and fiber content), the method of food processing and preparation, the combination of foods eaten, and physiological factors including age and body composition.

Glucose control is the net effect of metabolic processes that remove glucose from the blood for either glycogen synthesis or energy production and of gluconeogenesis and glycogenolysis, which return glucose to the blood.

The rise in blood glucose after consumption of a carbohydrate triggers the release of insulin and at the same time reduces the secretion of glucagon. Hyperinsulinemia, in turn, appears to be primarily responsible for many of the untoward metabolic problems associated with our present society, including obesity, hypertension, and cardiovascular disease.

Gary Taubes: Good Calories, Bad Calories
The recommendations found in this paper (1) are in agreement with the recommendations Gary Taubes, makes in his book, entitled Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (2) As I discussed in a recent blog post, in that book Taubes convincingly states that the problem with our diets lies in refined carbohydrates and sugars. He states that refined carbohydrates do harm via their dramatic and long-term effects on insulin, the hormone that regulates fat accumulation, and that the key to good health is the kind of calories we take in, not the number. There are good calories, and bad ones.

Robert Lustig: Sugar: The Bitter Truth
The recommendations found in this position paper are also in agreement with the recommendations Dr. Lustig makes in this lecture called “Sugar: The Bitter Truth” which was posted on YouTube. Dr. Lustig has also published extensively on this topic (3), and is also an co-author on the ADA's position paper on dietary sugar intake (1). Lustig calls fructose a "poison" and compares its metabolic effects with those of ethanol. See my previous blog post for more information.

How Do Dietary Sugars Relate to Animal Nutrition? 

Over the past five years, sugar has increasingly been added to some popular brands of dog and cat treats to make them more palatable and profitable (4-7). Like people, these sugars are not needed for our dogs or cats and are best avoided (7). These sugary treats are likely contributing to the rapid rise in obesity in our pets. Sugar is also added to pet foods and treats for a variety of reasons, other than those related to palatability. For example, corn syrup is used as a thickener and to suspend the dough for proper mixing of ingredients, and dextrose is used to evenly distribute moisture throughout a food (4). Sugar has a role in the physical and taste characteristics of many products, helping to mask bitter flavors imparted by acidifying agents, or changing the texture of specific treat types.

Why is the sugar content so high in many pet food treats and some pet foods? Remember that dogs, like humans, are omnivores and both species handle carbohydrates in much the same manner. Cats, on the other hand, are obligate carnivores, so sugars should never be included in their diet, if possible (8).

References:

1. Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, Sacks F, Steffen LM, Wylie-Rosett J; American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism and the Council on Epidemiology and Prevention. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009;120:1011-1020. http://circ.ahajournals.org/content/120/11/1011.full.pdf+html
2. Taubes G: Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease 2007.
3. Lustig RH. The fructose epidemic. The Bariatrician 2009:10-18. 
4. Healthday, December 08, 2010. Those Sweet Pet Treats May Foster Fatness: Sugar appearing more now in dog and cat treats as veterinarian warns of the consequences. 
5. Press Release, Association for Pet Obesity Prevention (www.petobesityprevention.com), June 17, 2010. Kibble Crack – Vet Exposes Sugary Secret of Pet Treats. Sugar is being added to many pet treats contributing to the growing pet obesity epidemic. 
6. Petfood Industry (www.petfoodindusty.com), December 13, 2010. Sugar in pet treats may be contributing to obesity. 
7. The Dog Food Project (www.dogfoodproject.com). Ingredients to avoid.
8. Kienzle, E. Blood sugar levels and renal sugar excretion after the intake of high carbohydrate diets in cats. The Journal of Nutrition 1994; 124:2563S-2567S.

Why y/d? Reasons Not to Feed Your Hyperthyroid Cat the Hill's y/d Thyroid Diet

Comprehensive Section on the Pros and Cons of Feeding the Hill's y/d Feline Thyroid Health Diet Added to the Animal Endocrine Website

Dr. Peterson has updated the Animal Endocrine website to provide more in-depth analysis of Hill's new y/d diet being heavily marketed as a treatment for cats with hyperthyroidism. The updated page includes information about the causes of hyperthyroidism, the role of iodine deficiency in this process, and the possible effects of and fallout from feeding y/d diet to a hyperthyroid cat.

There's a difference between using a iodine-deficient diet to address a cat's thyroid hormone levels, and actually treating and abating the disease. Dr. Peterson also has concerns about the nutritional composition of the y/d diet, which, in his opinion, is severely lacking.

Click through to our website to read the full article.

Related links: discussion of the y/d diet on Dr. Peterson's Insights into Veterinary Endocrinology blog.

Dr. Mark Peterson Interviewed for "My Pet World" News Column About Treating a Geriatric Hyperthyroid Cat

My Pet World: Advice from the Experts

By Steve Dale, Tribune Media Services 

Q: The thyroid levels for my 21-year-old cat have recently become elevated, indicative of early stage hyperthyroidism. My veterinarian recommended a prescription diet (Hill's prescription y/d) or transdermally administered methimazole. The veterinarian believes radioactive iodine is a bit too extreme for a cat of this age.

I'm worried that my cat will find the (prescription) diet unpalatable. I'm also concerned about the side effects of transdermal medication. I'm impressed with what I've read about a natural solution called Resthyro. What's your opinion on what I should do for my feisty geriatric cat? -- N.M., Highland Park, IL

A: Dr. Mark Peterson, of New York City, is one of the world's experts on this topic, and helped create the radioactive iodine treatment you mention. Hyperthyroid disease nearly always occurs in older cats. Still, he says he understands that with a cat as elderly as yours, there are limits on what it makes sense to do. "I can see where this cat is no candidate for radioactive iodine," he commented. This treatment typically cures hyperthyroid disease, and is benign, but takes the cat away from home for several days of treatment.

Peterson says he doesn't personally see many adverse reactions to transdermal medication (delivering medication through the skin rather than a pill) for hyperthyroid disease. And he's seen a lot of hyperthyroid cats. Of course, side effects can potentially occur with any medication, but sometimes what you read on the Internet may be skewed. The pill version of methimazole may be just fine, but you no doubt know it can be hard to convince a cat to take a pill, which is why the transdermal might be preferred.

As for the new Hills prescription y/d diet, Peterson says, "It's long-term safety for real use is unknown." He's not absolutely convinced about the diet, and agrees that any diet change might be a problem for a 21-year-old pet. Still, that's a possible option.

As for Resthyro, Peterson said he has not seen much success. If you want to try the "natural" route, ask your veterinarian about L-Carnitine (a nutritional supplement available wherever vitamins and supplements for people are sold). Peterson says if your cat is mildly hyperthyroid, this may the best option worth trying, but do monitor your cat's thyroid levels. Open the capsule and sprinkle the contents on your cat's food or a special treat, such as a bit of chicken. Try starting at 250 mg daily. 

Links to Original Article:

• Chicago Tribune, http://www.chicagotribune.com/entertainment/books/sns-201112131830--tms--petwrldctnya-a20111215dec15,0,405315.story
• Hartford Courant,             http://www.gadzoo.com/hartfordcourant/Article.aspx?id=107094

About Steve Dale:
Steve Dale, pet expert and certified dog and cat behavior consultant, reaches more pet owners than any other pet journalist in America. Steve writes a twice-weekly syndicated newspaper column (Tribune Media Services).

He is also a contributing editor at USA Weekend and is the host of two nationally syndicated radio shows, Steve Dale’s Pet World and The Pet Minute, and Steve Dale’s Pet World at WLS Radio, Chicago.  To learn more, visit Steve's website at www.stevedalepetworld.com.

What We Can All Learn From Older Animals

It is not hard to argue that we live in a youth-centric culture, one in which young age and beauty are almost synonymous. And that obsession does not end with humans. Puppies and kittens melt hearts; images and videos of baby animals flood the Internet. But rarely does an image of an animal in old age ignite the same interest and adoration.

Mortality and aging are never an easy subject to discuss. Finding meaning and joy in life in the face of physical limitations and challenges.

In an unusual project, Isa Leshko, a fine-art photographer who lives in Philadelphia, set out to capture glimpses of animals at a time when they rarely attract much admiration or media attention — in their twilight years (1). The photographs, part of a series called “Elderly Animals”, are intimate and at times gripping (2).

You can view more photos at Ms. Leshko’s Web site (3), which also contains a short documentary by Mark and Angela Walley about her “Elderly Animals” project (4).

Links:
1. The New York Times Well Blogs. What we can learn from old animals. December 29, 2011.
2. http://isaleshko.com/elderly-animals/
3. http://www.isaleshko.com/index.cfm
4. http://vimeo.com/29632448

Dr. Mark Peterson Receives Prestigious Award from The New York State Veterinary Medical Society

On December 8, 2011, Dr. Mark Peterson was awarded the President's Citation from the New York State Veterinary Medical Society.

This award to given to Mark in recognition and appreciation of his outstanding guidance and success in his role in organizing the speakers for the program of the annual New York State Veterinary Conference.

Dr. Mark Peterson awarded the President's Citation by Dr. Eric Bregman (on right),
the current President of the New York Veterinary Medical Society

The New York State Veterinary Conference provides three days of high-quality continuing education to hundreds of veterinarians, veterinary technicians, and students from across New York State and throughout the Northeast. This conference is hosted by the New York State Veterinary Medical Society and Cornell University's College of Veterinary Medicine and is held each fall in Ithaca, New York.