12a Nutritional Diseases and Wellness Diets 2

Question 1

What is FLUTD?

Answer 1

• Feline lower urinary tract disease
• 0.5-1% of pet cats
• disease of adult cats (2-6y)
• not single disease but a syndrome (crystals along not diagnostic)

Question 2

What are some clinical signs of FLUTD?

Answer 2

• non specific
• depend on lication, size and number of crystals or uroliths
• frequent urination
• urination at appropriate places
• hematuria (bloody urine)
• strong odour of ammonia
• painful urination (prolonged squatting or frequent licking)
• partial or total urethral obstruction
• complete obstruction v painful and could result in bladder rupture

Question 3

What to do if urethral obstruction occurs?

Answer 3

• fluid replacement therapy
• flushing out of urolith
• relief of bladder distension
• possibly surgery

Question 4

What is the difference between struvite and calcium oxalate crystals?

Answer 4

• now higher incidence of calcium oxalate than strive
• calcium oxalate pH too low
• struvute pH too high

Question 5

What are the conditions needed for struvite crystal formation?

Answer 5

• high concentration of composite minerals (magnesium, phosphorous, ammonium)
• sufficient time in urinary tract to allow crystallization
• pH >7
• small volumes of concentrated urine
• no relation to UTI (usuallty secondary infections)

Question 6

What are the conditions needed for calcium oxalate crystal formation?

Answer 6

• precipitate in acidified urine (pH 6.3-6.7)
• some cats have mild acidemia (induced by consumption of acidified diet; metabolic effect: production of acidified urine, increased serum calcium and urinary calcium excretion; formation of calcium oxalate crystals)

Question 7

Dietary management of struvite FLUTD

Answer 7

• dietary dissolution can take months (formulated to reduce Mg concentration and produce acidic urine)
• monitor for struvite dissolution for 2-4 weeks
• feed special diet for 1 month following complete dissolution
• switch to maintenance diet for prevention
• canned food to increase water intake (increase urinary volume and lower specific gravity)

Question 8

What are some dietary ingredients that increase urinary acid excretion?

Answer 8

• proteins of animal origin, corn gluten meal, methionine, phosphoric acid
• avoid large amount of cereal grains

Question 9

Management of calcium oxalate FLUTD.

Answer 9

• CANNOT be dissolved by calculolytic diet

- must be removed be surgery or urohydropropulsion

Question 10

What should the diet composition for calcium oxalate FLUTD be?

Answer 10

• reduce urinary concentrations of calcium and oxalate
• maintain dilute urine with pH 6.5-6.9
• highly digestible ingredients
• optimal levels of Ca and Mg (high Mg prevents calcium oxalate but increases risk of struvite)
• canned food to increase urine volume

Question 11

What is chronic kidney disease?

Answer 11

• dogs and cats with kidney disease have progressive loss of functioning nephrons
• clinical signs only appear with 70-85% loss of functioning nephrons
• onset of chronic kidney disease when compensatory mechanism of kidney breaks down
• 15% of elderly cats and dogs suffer under renal insufficiency

Question 12

What are some potential underlying causes of chronic kidney disease?

Answer 12

• trauma
• infection
• immunological disease
• tumors
• ischemia
• exposure to toxins
• older age
• in most cases underlying cause no longer present

Question 13

What are some clinical signs of chronic kidney disease?

Answer 13

• increased water intake (polydypsia) and increased urination
• reduced capacity to concentrate urine
• increased volume of urine
• higher water intake to maintain fluid balance
• azotemia: accumulation of nitrogenous wastes
• uremia: accumulation of urea in blood
• decreased appetite or anorexia
• vomiting
• depression
• electrolyte and pH disturbances
• mucosal ulcers
• weight loss
• bone demineralization
• anemia due to inability of kidneys to produce erythropoietin
• some dogs: chronic diarrhea, staggering or disorientation

Question 14

Dietary management of chronic kidney disease.

Answer 14

• diet may minimize clinical signs and contribute to overall longevity
• diet containing high quality protein that meets but does not greatly exceed the maintenance requirements should be fed (reduce work kidney has to do to remove nitrogenous end products)
• food should provide adequate calories from carbs and fat
• food should be highly palatable to prevent anorexia
• extra water soluble vitamins if polyuria leads to excessive losses
• food should be restricted in phosphorous
• inclusion of potassium citrate to control metabolic acidosis
• food should contain fermentable fibre to increase cecal N excretion
• food should contain omega 3 fatty acids to reduce renal inflammation
• restriction of dietary Na if secondary hypertension develops

Question 15

Why should we feed a diet that does not exceed maintenance protein requirements?

Answer 15

• restriction of protein does not halt renal disease
• cats do not tolerate severely restricted protein diets
• in dogs, restrict dietary protein with clinical signs of uraemia
• protein should only be restricted as necessary to control clinical signs

Question 16

Developmental orthopaedic disease in dogs

Answer 16

• hip dysplasia (abnormal development or growth of hip joint)
• nutritional secondary hyperparathyroidism
• osteochondrosis (abnormal cartilage development in growing bones)

Question 17

Development orthopaedic disease in horses.

Answer 17

• angular limb deformities
• flexural limb deformities
• physitis
• subchondral bone cysts
• cervical vertebral malformation
• osteochondrosis

Question 18

Describe growth of bones.

Answer 18

• initially grow by forming cartilage template onto which calcium is deposited to form bone
• bone ends grow in 2 places: epiphyseal plate and cartilage

Question 19

How does osteochondrosis affect bone growth?

Answer 19

• causes inadequate blood supply to reach cartilage
• creates thickened cartilafe layer
• over time, abnormal cartilage is weakened
• causes inflammation and arthritic changes

Question 20

What are the 3 primary forms of osteochondrosis?

Answer 20

1. ununited anconeal process: ossification of anneal process in elbow is impaired and fusion with ulna does not occur
2. fragmented coronoid process: also occurs in elbows, can occur in as little as 8 months, common in Bernese mountain dogs, labs, retrievers
3. osteochondrosis dessicans: separation of flap of cartilage from underlying bone, most common form in dogs
   - all types cause arthritic changes

Question 21

Clinical symptoms of oesteochondrosis.

Answer 21

• lameness and pain in affected joint

- affect animals may try and compensate for lameness by restricting movement of affected joint

Question 22

Risk factors of DOD

Answer 22

• multifactorial process
• most critical period during growth before epiphyseal closure
• risk factors currently though to increase risk includes genetics (large breed), management (exercise or free choice feed) and nutrition (high energy food or excess Ca)

Question 23

Why do high energy foods increase risk of DOD?

Answer 23

• highly palatable energy dense
• fat content of diet must be considered
• high energy intake directly affects growth velocity via nutrient supply through changes in concentrations of growth hormone, T3, T4 and insulin
• increased hormoneal influences enhance mitotic activity of proliferative cartilage cells
• articular cartilage less well supported by solid bone plated in rapidly growing animals
• biomechanical stress induced by rapid weight gain during growth

Question 24

Why do high calcium foods increase risk of DOD?

Answer 24

• disturbed endochondral ossification, retained cartilaginous cores in distal radius and ulna and delayed skeletal maturation and growth of bone length
• absolute level of Ca in food important
• related to competition of Ca with other minerals or direct stimulation of hormone effects (PTH or calcitonin) or acid base balance
• higher blood calcitonin increases deposition of Ca in bones (decreased bone turnover, higher osteoblastic activity, less osteoclastic activity, increased endochondral ossification

Question 25

4 things to prevent DOD using diet.

Answer 25

1. determine if animal is at risk: breed
2. if at risk, control nutrients of concern through food composition and feeding method
3. do not add vitamin or mineral supplements to balanced foods (particularly Ca, P, it D and vit A)
4. determine animal’s BCS

Question 26

6 things to treat dogs affected with DOD.

Answer 26

1. determine nutritional imbalance
2. food should be formulated for large or giant breed puppies
3. food should be meal fed
4. if well balanced growth food was being fed and skeletal diseases occur, reduce intake by 25%
5. no vitamin or mineral supplements should be given with balanced food
6. treatment for specific problems: pain relief, exercise restriction, surgery

Question 27

6 things to treat horses affected with DOD.

Answer 27

1. determine nutritional imbalance
2. food should be formulated for young, growing foals
3. non fibre carbs should be meal fed; forages should be of lower quality and not exceed energy intake
4. if well balanced food was being fed, reduce non fibre CHO intake
5. no vitamin or mineral supplements horses eating well balanced food
6. treatment for specific problems: pain relief, allow voluntary exercise but restrict forced exercise

Question 28

Hyperkalemic periodic paralysis (HYPP)

Answer 28

• co dominant autosomal genetic disorder
• dominant gene so must be inherited from affect parent
• mutated gene codes for sodium channel (regulates cellular sodium and potassium content)

Question 29

Describe normal muscle function

Answer 29

• electrical gradient established (85mV) across cell membrane (sodium pumped out, potassium pumped in)
• maintenance of gradient, muscle at rest
• during contraction, conformational change of sodium channel (electrical gradient approached 0 mV, calcium released from storage sites)
• muscle remains contracted until calcium is re-questered in storage sites

Question 30

Clinical signs of HYPP.

Answer 30

• regulation of movement of sodium and potassium is disturbed (constant back leakage of sodium ions into cell)
• in extreme conditions, severe repetitive contractions (muscle fasiculations, first evident over rib cage and flank areas, signs of pain similar to colic)
• in severe episodes, contractions become titanic and may cause death due to respiratory failure
• serum potassium concentrations increase to >10mEq/L

Question 31

Dietary management of HYPP

Answer 31

• treatment to limit increases in serum potassium
• restriction of potassium intake most important
• largest source of potassium in horse’s diet is forage
• grass forages have LESS potassium than legumes
• grains not large problem as have <0.5% potassium (grain intake will stimulate insulin which may facilitate uptake of potassium)
• if nutritional control is insufficient, other interventions for uptake of potassium include: mild exercise, insulin release, administer other cations into extracellular fluid, diuretic increases excretion of potassium through urine