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Feline nutritional peculiarities
in health and disease
Nestlé PURINA Scientifi c Update on Nutrition
Feline nutritional peculiarities in health and disease 2
Feline nutritional peculiarities
in health and disease
Dr Clémentine Jean-Philippe, DVM, Ph.DEuropean Scientifi c Communication ManagerNestlé PURINA PetCare
Jean-Christophe Bouthegourd, PhD Research Scientist – Senior Nutritionist, Nestlé PURINA PetCare Amiens Product Technology Centre
To understand the cat’s complex and highly individual pattern of feeding it is important to consider its ancestry.
The evolution of cats as strict carnivores has resulted in notable anatomical, nutritional and metabolic adaptations.
The domestic cat (Felis catus) is an obligate carnivore adapted to a hunting lifestyle existing on an almost totally
animal diet. Its jaws, digestive system and behaviour have been developed to accommodate this behaviour.
Cats have a highly adapted metabolism with requirements for nutrients such as taurine, arginine, arachidonic
acid and preformed vitamin A, which are only found in meat and fi sh. Cats have a natural tendency to be
neophilic- preferring novel foods over familiar ones- probably to increase nutritional adequacy in the wild. With
a desert- dwelling ancestry, cats have also adapted physiologically to a dry environment with a lower thirst
stimulus than dogs and the ability to produce highly concentrated urine. Whilst this is benefi cial in the desert
it can predispose cats to the formation of urinary stones and crystals. Recent studies in feline nutrition have
confi rmed that adding bovine colostrum to the diet of healthy kittens helps provide local protection against
intestinal infections, helps stabilise gut microfl ora and stimulates a kitten’s immune system- helping improved their
immune response and enhance vaccination response. At the other end of a cat’s life, old age is associated with
a progressive loss of lean body mass in cats that may be mitigated in part by feeding higher protein levels. In
addition, a study showed that a diet containing supplemental antioxidants, PUFAs, and a prebiotic increased
longevity and improved health of senior cats.
Sick cats also have specifi c and unique nutrition needs. Diabetic cats’ exogenous insulin requirements can be
dramatically reduced when they are fed a high protein, low carbohydrate diet. Obese cats also benefi t from
high protein diets as high protein helps maintain lean muscle, reduce fat, increase satiety and improve weight
loss in overweight cats. Cats with FLUTD have been shown to benefi t from increasing their water intake- either
by using a wet diet or by adding moderate (1.2%) sodium levels (salt) to the diet. This level of salt has been
demonstrated to be safe in healthy adult cats. Stress is an under recognised cause of intestinal fl ora imbalance
in cats leading to clinical diarrhoea and/ or subclinical pathological changes in the gut. There are many proven
benefi ts to the addition of E. Faecium SF68® probiotic in cats and kittens including improved immune function
and microfl oral balance and stability, reduced incidence of conditions such as conjunctivitis and non specifi c
diarrhoea and improved faecal quality.
Feline nutritional peculiarities in health and disease 3
Feline Peculiarities in Health
Cats are obligate carnivores
Domestic cats (Felis catus) are obligate carnivores designed to eat a predominantly meat- based diet. Anatomically
they have teeth designed to seize and tear prey and a short simple digestive system with a quick digestive transit
(18- 24 hours). As obligate carnivores, some of the metabolic pathways and enzymes present in omnivores
are redundant in the cat. Cats’ natural diet is high in animal protein and fat and low in carbohydrate- the only
carbohydrates eaten being those semi- digested in the gut of their prey. Cats have very low levels of amylase
in their saliva and very low levels of enzymes designed to digest carbohydrates (amylase, maltase, sucrase)
in their digestive system. Despite this, cats are able to effi ciently digest cooked starch1 which can therefore be
useful as an energy source. The high protein requirement of cats is due to their high requirement for nitrogen.
This appears to be because cats have a limited ability to control the activity of their aminotransferases and urea
cycle enzymes2,3. Protein is also the main source of energy for cats. The lack of downregulatory control over
aminotransferases and urea cycle enzymes renders cats immediately able to metabolise and use amino acids for
gluconeogenesis and as an energy source4. There are several other nutrients considered essential in feline diets
that are not recognised as essential in most other species due to the low activities of enzymes in their synthetic
pathways. These are the amino acids arginine and taurine, niacin (vitamin B3), vitamin A and vitamin D. Cats
also require linoleic and arachidonic acid (omega- 6 fatty acids) as they lack the enzyme to synthesise them
from other food components.
Cats require variety
Feral cats are opportunistic hunters and generalist predators- if left to procure food on their own they select from
a wide range of prey rather than limiting themselves to a single food source which should increase the nutritional
adequacy of their diet. Cats tend to be neophilic- preferring novel or less familiar foods to familiar ones. This
may explain some types of fi nicky behaviour in our domestic cats5. A feeding study from Nestlé PURINA shows
that cats with a history of dietary variety will initially eat slightly less when offered a novel food for 5 consecutive
days, however, by the 5th day they will have returned to their normal eating pattern5. While domestic cats no
longer need variety for nutrition, they may need it for enjoyment.
Cats are small drinkers and have very concentrated urine
As cats have evolved from desert- dwelling animals which derived most of their water from eating their prey,
they do not have a strong natural urge to drink frequently. They can survive on less water than dogs and
compensate by producing very concentrated urine. The downside of this natural behaviour is that concentrated
urine increases the risk of urolithiasis and urinary crystal formation. In cats prone to FLUTD it may therefore be
necessary to provide intervention to increase cats’ water intake. Cats fed a wet diet retain more water and
produce more urine than those fed a dry food6. Adding 1.2% sodium (salt) to a healthy cat’s diet also increases
urine volume and reduces concentration of calculogenic materials in the urine. In a 6 month trial cats fed 1.2%
sodium experienced no signifi cant changes in blood pressure, renal function, weight, stool quality or general
health. Adding sodium at 1.2% to the diet of cats is therefore considered safe and effective in increasing urine
volume and reducing urine concentration7.
Kittenhood- support of the feline immune system
Amongst the patients seen in daily veterinary practice, young kittens are some of the most delicate ones,
Feline nutritional peculiarities in health and disease 4
being frequently presented for investigation of digestive upsets and various infections and infestations that can
sometimes be life threatening. The critical lifestage of kittenhood is not only a time when there is a strong demand
on the body for growth and development but also is a time when the immune system is still developing and thus
not functioning optimally and the intestinal microfl ora is still unstable. Kittens also undergo many stressful changes
during this period ranging from leaving their mother and siblings, to going to a new home and environment -
stressors which can adversely affect their intestinal microfl ora and challenge the function of their immune system.
During the fi rst year of life kittens also experience changes to their immune system. Up until weaning, kittens
receive antibodies and other immune components from their mothers’ milk which are vital to protect their health.
At weaning the antibody levels drop. Immunity reaches a low around 3 weeks of age which lasts until about 5
months of age when the immune system matures. This is known as the Immunity Gap.
There has been signifi cant recent interest in nutritional immunostimulation to support kittens during this Immunity
Gap. Bovine colostrum has been investigated as an immunostimulant as it is rich in growth factors, antibodies,
antimicrobial factors and prebiotics8. Studies were performed9 to assess if colostrum could have benefi ts on the
local and systemic immune system in weaned kittens and to evaluate its positive impact on the intestinal fl ora.
Twenty-four domestic shorthair kittens weaned at 12 weeks of age were included in a 44 week trial. Kittens
were allocated into one of 2 diet groups- group 1 were fed a high quality kitten food and group 2 were fed the
same diet supplemented with colostrum. All kittens received a feline rabies virus vaccine at time 0 and a booster
vaccine at week 36. During the test period, kittens were subjected to a mild stress (room relocation) in order to
evaluate the faecal microfl ora stability during a stress event. During the 44 weeks study health parameters were
regularly monitored.
The kittens fed with the test diet supplemented with colostrum showed a signifi cantly quicker and stronger
response to rabies vaccination. There was a 50% increase in antibody levels in the kittens fed the colostrum-diet
compared with kittens fed the control diet (fi gure 1).
Stimulation of the local intestinal immune system was also observed in the group fed the colostrum- supplemented
diet (fi gure 2). This enhanced local production of antibodies is likely to help protect kittens from potential intestinal
infections making them more able to cope with intestinal upsets.
These studies demonstrate that dietary supplementation with natural antibodies and other bio-actives found
in colostrum have benefi cial health effects in kittens. These compounds help to enhance the kitten’s immature
immune system to better respond to challenge, without overstimulation. The compounds also help stabilise the
gut microfl ora, lowering the potential for infection and stress-related diarrhoea. Based on this recent study, PRO
PLAN® kitten formulas have been formulated with OPTISTART®, containing natural antibodies and other bioactives
from colostrum, and have been proven to reinforce the kitten’s immune system.
Feline nutritional peculiarities in health and disease 5
Figure 2. Colostrum stimulates GALT increase secretory IgA
30
25
20
15
10
5
0
Normalised
faecal IgA
Colostrum * : p<0.05Control
*
Figure 1. Colostrum enhances systemic immune status in kittens
Week 36 Week 40
70
60
50
40
30
20
10
0
Specifi c anti-rabies lgG level titres IU
/ml
Colostrum * : p<0.05Control
S
*
Feline nutritional peculiarities in health and disease 6
7+ cats need high levels of high quality dietary protein
Cats over 7 years of age experience:
• Increased Maintenance Energy Requirements- In contrast to dogs and humans, elderly cats may experience
an increase in their maintenance energy requirements. This is due to a better-maintained basal metabolic rate
and progressive compromise in fat and protein digestion.
• Reduced Digestive function- Mature/ senior cats have a lower capacity to digest fat, fat-soluble vitamins and
protein. Around one third of cats over the age of 12 do not digest fat and fat soluble vitamins effi ciently.
They also experience a higher probability of imbalanced microfl ora and reduced stool quality.
• Loss of lean body mass (fi gure 3) - This can be mitigated in part by feeding high dietary protein levels.
• Variability in body condition (obese then frail) - Maintenance energy requirements decrease as cats mature
and become middle-aged (4-9 years of age), explaining the tendency of many cats to gain weight during
this time10,11.
• However, energy requirement sharply and progressively increase again in these cat when they become
older, starting at 10 to 12 years of age10,11. If daily caloric intake is not increased, progressive weight loss
will result, due in large part to the loss of lean body mass (i.e., muscle mass), a phenomenon referred to the
“sarcopenia” of ageing11,12.
• Lower spontaneous activity.
• Increasing likelihood of diseases that may need nutritional intervention.
Diets designed for healthy elderly cats should therefore concentrate on being energy dense, highly digestible
with high levels of high quality protein and with an increase in the proportion of protein calories, and being fed
with the aim of supporting optimal body weight. There is no evidence to suggest that feeding healthy elderly
cats a restricted protein diet will mitigate the risk of them developing renal failure13,14,15.
3500
3000
2500
2000
1500
1000
Lean tissues (g)
Figure 3. Loss of lean body mass in ageing cats
Years
1-3 3-5 5-7 7-9 9-11 11-13 13-15 15-17 17-20
Feline nutritional peculiarities in health and disease 7
Mature/senior cats- nutrition can extend healthy lifespan
Recent studies16,17 have proven that cats aged 7 years plus, when fed exclusively on a diet containing supplemental
antioxidants, prebiotic fi bres (chicory root), and fatty acids lived signifi cantly longer whilst enjoying good health.
90 healthy cats aged 7- 17 years were split into 3 equal groups. Group 1 cats were fed a nutritionally complete
adult cat food (diet 1). Group 2 were fed diet 1 with added antioxidants (vitamin E and � carotene) and group
3 were fed diet 1 with a blend of added nutrients known as Longevis®- antioxidants (vitamin E and � carotene),
prebiotics (chicory) and omega- 3 and 6 fatty acids.
Results revealed that senior cats fed the diet containing the Longevis® blend lived signifi cantly longer than cats
fed a standard nutritionally complete cat food (fi gure 4). A positive impact on gastrointestinal and endocrine
systems was also seen suggesting that Longevis® may contribute to improvements in health as well as increased
longevity. Diet 2 (antioxidants only) had no signifi cant difference compared to diet 1 (control).
Cats fed Longevis® also:
• Had stable food intake.
• Maintained better lean bodyweight and bone density
• Maintained higher vitamin E levels.
• Maintained healthier blood parameters.
• Maintained better skin thickness.
• Maintained better balanced intestinal microfl ora
Figure 4. Cats fed longevis® blend had a longer healthy lifespan
16
15.5
15
14.5
14
13.5
Age (Yea
rs) at d
eath
Control Antioxidant Longevis
Feline nutritional peculiarities in health and disease 8
Feline peculiarities in disease
Diabetes Mellitus and Carbohydrate Metabolism
Traditional diets recommended for cats with Diabetes Mellitus have been high in fi bre to help reduce glucose
fl uctuations with moderate carbohydrate levels. However, while healthy cats are able to readily use carbohydrates
in good quality diets, diabetic cats may not be able to do so as effi ciently. A cat’s blood glucose concentration
results from a balance between glucose entering the blood (either from gluconeogenesis or absorption from the
diet) and the rate of cellular glucose uptake through insulin- mediated and non- insulin mediated mechanisms.
Replacing dietary carbohydrate with protein appears to be an effective means of slowing the release of glucose
into the bloodstream. Numerous studies have confi rmed the benefi t of high protein, low carbohydrate diets for
diabetic cats, with decreased insulin requirements and/ or enhanced glycaemic control when the cats were fed
a high protein diet. In fact a number of diabetic cats that received high protein (10- 15g protein/ 100 kcal
ME), low carbohydrate (1.7- 3.5g/ 100 kcal ME) diets along with insulin therapy were able to discontinue
exogenous insulin altogether18,19,20.
In one study, 9 cats previously fed a high fi bre diet were transitioned onto PURINA VETERINARY DIETS DM
Diabetes Management®- a high protein, low carbohydrate diet. After 8 weeks all cats were in excellent health.
3 cats no longer required any insulin and all the others were on reduced doses of exogenous insulin without
compromising glucose control (See fi gure 5). Collectively all cats fed DM had a signifi cantly reduced exogenous
insulin requirement18.
Figure 5. Change in insulin dosage in diabetic cats fed Purina Veterinary Diets DM Diabetes Management*
Insulin requirements decreased for 89% of cats completing this 8-week trial, from a mean of 4.8 U/day to 2.0 U/day. Three of the nine cats longer required exogenous insulin at the end of the study.
*As published in Veterinary Therapeutics, Vol 2, N3, Summer 2001.
Insulin Level Before DM Insulin Level After DM
20
15
10
5
0
Insulin dose,Units/d
ay
Cat A Cat B Cat C Cat D Cat E Cat F Cat G Cat H Cat I
(0) (0)(0)
Feline nutritional peculiarities in health and disease 9
FLUTD (Feline Lower Urinary Tract Disease)
Feline Lower Urinary Tract Disease (FLUTD) is very common in cats- affecting 4- 10% of cats admitted to veterinary
hospitals. The incidence increases with stress, inactivity, an indoor lifestyle, neutering, obesity, genetics and
infrequent urination/ low water consumption. Although it can affect cats of any age the incidence peaks in
cats aged 2- 6 years of age. FLUTD is a syndrome with many causes but the top three are Feline Idiopathic
Cystitis, urolithiasis (mainly struvite and calcium oxalate) and urethral plugs. Management of FLUTD includes a
dietary change, reducing environmental stress and increasing water intake. Diets to manage FLUTD should be
designed to:
• Reduce saturation of urine with urolith precursors & crystals
• Urine undersaturated or metastable .
• Increase urine dilution.
• Optimise urine pH.
• Reduce risk of obesity.
• Support the bladder lining (Glycosaminoglycans).
• Help reduce urinary tract infl ammation (Omega- 3 fatty acids).
• Be easy to use (i.e. manage all 3 main causes of FLUTD).
In order to increase urine volume and dilution in cats with FLUTD veterinary surgeons recommend a number of
strategies:
• Feed a canned food- Cats who consume canned food take in more water (from food and water) than
cats who consumer dry food (278 ml vs. 227 ml/day) and produce greater urine volume (166 ml vs. 79
ml/day).
• Encourage greater drinking from the water bowl.
• Fresh water in metal or ceramic bowl- never plastic as this can taint the taste of the water.
• Fill the bowl right to the top so the cat can see the attractive glistening on the surface of the water.
• Use a large water bowl so the cat’s whiskers do not touch the bowl whilst she is drinking.
• Cats are often attracted to drinking running water- running water fountains can be purchased for cats (or
leave a tap dripping).
• Locate water bowls in a peaceful location away from litter tray.
• Feed a diet containing added salt (1.2% sodium). 1.2% sodium is safe for healthy adult cats and signifi cantly
increases urine volume and reduces urine specifi c gravity7.
Feline nutritional peculiarities in health and disease 10
Obesity in cats
Obesity is a common and growing problem in the European cat population. High protein has been shown to
help obese cats in a number of ways:
• High protein helps maintain lean muscle and increases fat loss21: In a study of 8 healthy but overweight adult
female cats, half the cats were fed a high protein (HP) diet (40% dietary crude protein as fed) and the other
half were fed a normal protein (NP) diet (30% dietary crude protein as fed). Both groups were fed the
appropriate calorie levels to achieve a 1% weight loss per week. Serum biochemistry and dual energy x-ray
absorptiometry (DEXA) analysis were assessed. DEXA allows for the assessment of the cats’ body composition.
Cats fed the high protein diet during weight loss preserved their lean muscle tissue and lost more fat than
those fed normal moderate protein levels (fi gure 6).
• High protein helps increase satiety: High protein diets decrease subsequent energy intake at the next meal
compared to lower protein diets. The mechanisms for this are unclear but there are several theories:
• A “satiety centre” may exist in the brain which is sensitive to amino acid levels in the blood and once
levels reach a certain point, hunger would cease. Therefore cats fed a high protein diet would have
higher blood amino acid levels which would “shut off” hunger.
Figure 6. Feeding high dietary protein reulted in greater fat loss and greater retention of lean body mass compared to feeding normal protein levels
For both loss of lean and loss of fat, the effect of diet was signifi cant, p = 0.0114
100
95
90
85
80
75
70
30
25
20
15
10
5
0
Percent o
f weight lo
ss Percent of weig
ht lost
Fat Loss Lean Tissue
NP NPHP HP
*
*A B
Feline nutritional peculiarities in health and disease 11
• High protein diets lead to higher CNS leptin sensitivity. Leptin is a hormone whose levels increase in
proportion to body fat levels- and it acts on the brain to inhibit appetite. An increase in dietary protein
from 15% to 30% of energy at a constant carbohydrate intake produces a sustained decrease in ad
libitum caloric intake that may be mediated by increased central nervous system leptin sensitivity and
results in signifi cant weight loss.
• High protein helps improve weight loss:
• Due to increased satiety and decreased subsequent energy intake.
• Due to an increase in energy expenditure (greater “thermic effect”) - The thermic effect of a food is the
increase in energy expenditure above baseline following consumption. Typical thermic effect of protein is
20%–35% of energy consumed and for carbohydrate this number usually falls to between 5% and 15%.
Proven benefi ts of probiotics in cats
Probiotics are live organisms that when administered in adequate amounts confer a health benefi t for the
host22,23. Considerable scientifi c research has led to a clearer understanding of the value of probiotics in
the treatment and prevention of a number of disorders23-25. The most widely studied probiotics are strains of
lactobacillus, bifi dobacterium, enterococcus and saccharomyces23-26. The benefi cial effects of probiotics may be
both species- and strain-specifi c. To ensure appropriate viability of the organism, very careful production and
stabilisation methods are required22.
Probiotics have two broad mechanisms of action but within each of these the interactions are complex
and varied:
• Modifi cation of the bacterial fl ora of the intestinal tract, for example by:
• Inhibiting growth of pathogenic bacteria.
• Inhibiting the adhesion of pathogenic organisms to the intestinal epithelium.
• Production of bacteriocins (proteins that inhibit other bacteria).
• Enhancing mucus production.
• Reducing the luminal pH.
• Modulation of the immune system, for example by:
• Binding to Toll-like receptors and stimulation of innate immune responses.
• Improved epithelial barrier function (including reduced permeability).
• Enhanced IgA production and appropriate immune responses.
• Modifi cation of cytokine responses to reduce excessive infl ammation.
The cat’s intestinal fl ora can become imbalanced for many reasons usually relating to stress. These include during
kittenhood and at the senior lifestage, as a result of dietary or environmental change or travel and as a result of
infections or broad spectrum antibiotic usage. The consequences of intestinal fl ora imbalance include clinical
diarrhoea or subclinical changes in the gut such as increased shedding of pathogenic bacteria, reduced function
Feline nutritional peculiarities in health and disease 12
of the protective intestinal barrier, inconsistent faecal quality and increased susceptibility to disease.
PURINA VETERINARY DIETS FortiFlora® contains a strain of E. faecium (SF68®) (E 1705) - a lactic acid
bacterium that is recognised as a safe, ‘friendly’ bacteria, and valuable probiotic. A unique and proprietary
microencapsulation technique ensures the bacteria in FortiFlora® remain viable, and that the product can be
used with confi dence in its effi cacy. In cats, studies have confi rmed that feeding SF68® signifi cantly increases
benefi cial bacteria in the faeces and reduces quantities of potential pathogens (such as clostridia). In clinical
trials, SF68® has been shown to signifi cantly improve microfl oral balance and stability in cats and kittens,
improve the immune status of kittens, reduce the incidence of conjunctivitis in cats infected with feline herpes
virus-1 (FHV-1), prevent diarrhoea outbreaks in kittens and reduce non- specifi c diarrhoea in shelter cats27-30.
Based on these studies, FortiFlora® can be recommended for cats to support the nutritional management or
prevention of:
• Acute infectious and non-infectious enteritis (e.g. food intolerance, dietary indiscretion).
• Diarrhoea associated with GI microbial imbalance (e.g. stress, antibiotics, diet change).
• Poor faecal quality in kittens.
FortiFlora® may also have a role to play in other conditions such as:
• Chronic enteropathies, for example, infl ammatory bowel disease.
• Promoting optimal immune responses in health and disease.
Faecal clostridium perfringens in adult cats
Num
ber of Cats
Number cats positive for C. perfringens
6
5
4
3
2
1
Control E. Faecium SF68®
Feline nutritional peculiarities in health and disease 13
Percent o
f kittens trea
ted for diarroh
ea
SF68® prevents diarrhoea outbreaks in kittens
100
80
60
40
20
0
Control E. Faecium SF68®
Kittens fed SF68® had lower incidence of spontaneous diarrhoea than controls
% of faeces
SF68® improves faecal quality in cats with chronic diarrhoea
Control E. Faecium® SF86
100
80
60
40
20
0
Firm Soft, formed Slightly, formed Liquid
Feline nutritional peculiarities in health and disease 14
Further Reading
1. Kienzle E. Carbohydrate metabolism of the cat 2. Digestion of starch. Journal of Animal Physiology and
Animal Nutrition 1993; 69: 102-114.
2. Rogers QR, Morris JG, Freedland RA. Lack of hepatic enzymatic adaptation to low and high levels of dietary
protein in the adult cat Enzyme 1977; 22: 348-356.
3. Green AS, Ramsey JJ, Villaverde C et al. Cats are able to adapt protein oxidation to protein intake provided
their requirement for dietary protein is met. Journal of Nutrition 2008; 138(6): 1053-1060.
4. Morris JG. Idiosyncratic nutrient requirements of cats appear to be diet- induced evolutionary adaptations.
Nutrition Research Reviews 2002; 15: 153-168.
5. Nestlé Purina research 2001
6. Burger IH, Smith PM. Effects of diet on the urine characteristics of the cat. In: Proceedings. International
Symposium on Nutrition, Malnutrition, and Dietetics in the Dog and Cat, 1987; 71-73.
7. Xu H, Lafl amme DP, Bartges JW et al. Effect of Dietary Sodium on Urine Characteristics in Healthy Adult
Cats. J Vet Int Med. 2006; 20: 738 (Abstr).
8. Uruakpa F. Colostrum and its benefi ts: a review Nutrition Research 2002 22 (6), 755-767
9. Nestlé PURINA 2009 Study on 24 domestic short hair kittens during 44 weeks in Nestlé PURINA PetCare
Centres.
10. Perez-Camargo G. Cat nutrition: What is new in the old? Compendium for Continuing Education for the
Practicing Veterinarian 2004; 26(Suppl 2A): 5-10.
11. Lafl amme D. Nutrition for aging cats and dogs and the importance of body condition. Veterinary Clinics of
North America: Small Animal Practice 2005; 35: 713-742.
12. Wolfe RR. Sarcopenia of aging: Implications of the age-related loss of lean body mass. Proceedings of
the Nestlé Purina Companion Animal Nutrition Summit: Focus on Gerontology. St. Louis, MO. 2010; pp.
12-17.
13. Sparkes AH. Feeding old cats— An update on new nutritional therapies. Topics in Companion Animal
Medicine 2011; 26: 37-42.
14. Patil AR, Cupp C, Pérez-Camargo G. Incidence of impaired nutrient digestibility in aging cats. Nestlé Purina
Nutrition Forum Proceedings. 2003; 26,2(A):72.
15. Wakshlag JJ. Dietary protein consumption in the healthy aging companion animal. Proceedings of the Nestlé
Purina Companion Animal Nutrition Summit: Focus on Gerontology. St. Louis, MO. 2010, pp. 32-39.
16. Cupp CJ, Philippe C, Wendell WK, et al. Effect of nutritional interventions on longevity of senior cats. Intl
J Appl Res Vet Med. 2006; 4: 34-50.
17. Cupp CJ, Kerr WW, Jean-Philippe C, et al. The role of nutritional interventions in the longevity and
maintenance of long-term health in aging cats. Intl J Appl Res Vet Med. 2008; 6: 69-81.
Feline nutritional peculiarities in health and disease 15
18. Frank G, Anderson W, Pazak H, et al., Use of a high protein diet in the management of feline diabetes
mellitus. Vet Ther. 2001; 2: 238-246.
19. Marshall RD, Rand JS. Insulin glargine and a high protein- low carbohydrate diet are associated with high
remission rates in newly diagnosed diabetic cats. J Vet Intern Med. 2004; 18: 401
20. Bennett N, Greco DS, Peterson ME, et al. Comparison of a low carbohydrate- low fi ber diet and a
moderate carbohydrate- high fi ber diet in the management of feline diabetes mellitus J Feline Med Surg.
2006; 8: 73-84
21. Lafl amme DP, Hannah SS. Increased Dietary Protein promotes Fat Loss and Reduces Loss of Lean Body
Mass During Weight Loss in Cats. Intern J Appl Res Vet Med. 2005; 3: 62-68.
22. Wynn SG. Probiotics in veterinary medicine. J Am Vet Med Assoc. 2009; 234: 606-613.
23. De Roos NM, Katen MB. Effects of probiotic bacteria on diarrhoea, lipid metabolism, and carcinogenesis:
a review of papers published between 1988 and 1998. Am J Clin Nutr. 2000; 71: 405-411.
24. Culligan EP, Hill C, Sleator RD. Probiotics and gastrointestinal disease: successes, problems and future
prospects. Gut Pathog. 2009; 1;19-31.
25. Marteau PR; de Vrese M, Cellier CJ, et al. Protection from gastrointestinal diseases with the use of probiotics.
Am J Clin Nutr 2001; 73: 430S-436S.
26. Kligler B, Cohrssen A. Probiotics. Am Fam Phys. 2008; 9: 1073-1078.
27. Lappin MR, Veir JK, Satyaraj E, et al. Pilot study to evaluate the effect of oral supplementation of Enterococcus
faecium SF68 on cats with latent feline herpesvirus 1. J Feline Med Surg. 2009; 11: 650-654.
28. Veir JV, Knorr R, Cavadini C, et al. Effect of supplementation with Enterococcus faecium (SF68) on immune
functions in cats. Vet Ther. 2007; 8: 229-238.
29. Bybee SN, Scorza V, Lappin MR. Effect of the probiotic Enterococcus faecium SF68 on presence of diarrhea
in cats and dogs housed in an animal shelter. J Vet Intern Med. 2011; 25(4): 856-60.
30. Nestlé PURINA research 2007.