Kaiser is an entire Male Leonberger who was referred as a 10 month old for management of Elbow Dysplasia and multiple conformational abnormalities. Kaiser has a complex history and has also had a complex treatment programme. Part of which has been managing his nutrition to help him to build muscle. 
We started seeing Kaiser before our new online portal was implemented but his owner was very engaged over email in helping us to try and address his overall nutrition.
Unfortunately the main issue with Kaiser was just that he was not a very ‘hungry’ dog and had early GI issues as a puppy so was being fed AVA Sensitive and RAW as his main diet. His owner had also got into the habit of giving him a lot of daily treats, as he didn’t eat enough of his main food, which meant that his overall nutrition was far from balanced. An added component (which is a common component to consider) was the affordability of any potential change in diet, as Kaiser is obviously a large breed dog and we were aiming for a target weight of ~70kg (at his lowest weight, in adolescenthood, Kaiser was 59.65kg).

We looked at changing the provider of the RAW component of his diet to one with a higher quality protein content and did the same for the sensitive dry kibble (ensuring it was affordable for the owner). We also increased the feeding volume, even though Kaiser would often leave food, and recommended using fewer daily treats in the hope this would make Kasier hungrier and therefore more likely to eat his main diet. Often looking at changes in our patients’ feeding routine is just as important as addressing the diet being fed. We also added in an oily fish to help increase fat and protein within the diet.
These changes made a big difference and we started seeing positive changes in Kaisers BCS, especially in the muscle coverage over his hindlimbs, which had been our main goal (also with his home exercise plan to support what we were doing in clinic). 

Honestly though, Kaiser continues to be a challenge to manage long term, as he is still a finickity eater and we often have to revisit his feeding plan and make changes as necessary. We have managed to get his weight over 70kg at times, and overall the changes in his BCS are maintained, but we are still aiming to improve this further.
Kaiser currently weighs 68.4kg, and his mobility is far improved, so we are hopeful with increases in exercise and continued input with his diet we will get there. He is such a lovely boy.