3b. Rx Diets Flashcards

1
Q

What are omega 3 fatty acids?

A

a-linolenic acid (ALA)
eicosapentaenoic acid (EPA)
docosahexaenoic acid (DHA)

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2
Q

What is a-linolenic acid?

A

short chain fatty acid
found in plant sources such as nuts and seeds (ex. flax, canola)
ALA is converted in the body to EPA and DHA (poorly in D/C)

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3
Q

What is eicosapentaenoic and docosahexaenoic acid?

A

long chain fatty acid
found primarily in marine sources like cold water fish (salmon and other fish oils)
direct sources of EPA and DHA are preferable to ALA-based sources due to poor conversion by D/C
DHA lvls are highest in retina/brainsperm cells

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4
Q

What is EPA and DHA’s role in the body?

A

incorporate into the cell membrane - makes cell membrane more stable to inflam
eicosanoids take part in cellular signaling pathways in heart cells, immune cells and endocrine system
action is through inhibition of the prostaglandin pathway, leukotriene pathway and COX2 pathway
the also inhib movement of neuts and inhib activity of various cytokines

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5
Q

What effects does EPA and DHA have on the body?

A

Anti-inflam: skin dz, urinary condistions, GI conditions and osteoarthritis
repro and growth: important for development of many body systems, can improve learning cap. in puppies
Cardiac and renal: blood thinning (reduce plasma fibrinogen, anti-hypertensive actions)
Aging: improve athletic performance and brain oxygenation
Neoplasia - limit risk of tumors

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6
Q

What is the goal of treating anxiety in patients/

A

to reduce stress and associated clin. signs, improve emotional stability
Anxiety related to various medical conditions, often associated w/ past experiences
can worsen or present w/ advanced age due to decline in other senses
in extreme cases or behavioural cases, nutraceuticals often not enough (need training, socialization, desensitization and medical therapy

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7
Q

What is L-tryptophan?

A

essential AA
metabolic precursor to serotonin and melatonin
Implicated in many behaviour processes like mood, aggression, susceptibility to stress
Tx of behaviour disorder in cats - repetitive behaviour, vocalization, agonist behaviours

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8
Q

What is A-casozepine?

A

Casein
derived from milk protein, shownt o have a calming effect on babies, affinity for benzodiazepine site of GABA-a receptors, shown to have anxiolytic effect in dogs and cats

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9
Q

What is L-theanine

A

AA found in tea leaves
Inhibitor of glutamate - excitatory NT
reduces the excitatory effect
relaxing affect shown in lab anims, humans, dogs and cats

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10
Q

What are medium chain triglycerides

A

brain has reduced ability to utilize glucose w/ aging
MCTG provides alternative energy source for brain
protective of cognitive decline in epileptic dogs

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11
Q

What is join disease?

A

loss of cartilage, leads to remodeling and thickening of joints, affects entire joint and not just the cartilage
Goals: reduce comfort/pain, improve QoL, slow down progression, address contributing or aggravating factors, reduce inflam, prod healthy body weight

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12
Q

What might predispose animals to joint disease

A

Aging, obesity, trauma, genetics/breed, anatomy (conformation)

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13
Q

What are glycosaminoglycans?

A

important part of joint cartilage and synovial fluid
Stimulate the prod of proteoglycans and hyaluronic acid - important for shock absorption
Glucose: promotes synthesis of cartilage
Chondroitin: inhibs destruction of cartilage, helps w/ water retention, important for pressure resistance
Role is mostly chondroprotective

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14
Q

What is hydrolyzed collagen?

A

obtained by enzymatic hydrolysis of collagenous tissues
Promotes the regen of cartilage by providing key AAs like glycine, proline, hydroxyproline
Stims hyaluronic acid synth by synovial cells - results in the inc synthesis of type 2 collagen
role is primarily to inc cartilage development/regen

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15
Q

What are antioxidants?

A

Vitamines: E and C
Minerals: selenium and manganese
AAs: taurine, glutathione
Other: green tea polyphenols (also inhib inflam, inhib destruction of cartilage and promote collagen synthesis) combats oxidative stress

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16
Q

What is green lipped mussel used for?

A

perna canaliculus - species of mussel found in new Zealand
mussels act as a sea water filter and tend to retain essential nutrients
contain lg # of active substances like;
omega 3 fatty acids
chondroitin and glucosamine
Vitamin E and C
Zinc, copper, Manganese

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17
Q

What are some other diets an animal can be put on for joint disease?

A

weight loss if necessary - 6% reduction in weight has shown to improve mobility and QoL in dogs
Many multifunction options available
Multimodal therapy like analgesics, physiotherapy and alternative therapies

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18
Q

What is the goal of treating obesity?

A

promote healthy weight loss and restrict energy w/o restricting nutrients

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19
Q

What are the nutritional priorities of obesity?

A

reduced fat (calories)
reduced carbs (lower glycemic index)
increased fibre (satiating effect; lowers caloric density)
increased proteins (maintain lean body mass)
L-carnitine (promotes the use of fat as an energy source
Balanced lvls of nutrients, minerals and vitamins to ensure needs are being met despite marked caloric restriction

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20
Q

What are some other conditions to keep in mind with obesity considerations?

A

promote healthy exercise, carefully measure portions, smaller and more frequent feedings, consider treats, canned food or adding water to diet, prevention is key

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21
Q

Why might a patient have allergies?

A

proteins that we eat have epitopes on the surface
the cells in our bodies have matching IgE receptors
when we eat proteins to which a sensitivity has developed, the epitopes cross-link to two or more IgE receptors to “unlock” a histamine release - see inflam and the clinical signs of an allergic reaction

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22
Q

What are the goals of allergy diets

A

reduce the clinical signs associated w/ food allergies
cutaneous adverse food reactions: pruritus, skin infections, hair loss
Noncutaneous adverse food reactions: V/D
diets need to be formulated w/ extensive quality control methods to avoid the risk of protein contamination (off-label protein sources)

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23
Q

What are the nutritional priorities of allergy diets

A

appropriate protein source that does not elicit an allergic reaction
Novel protein - dependent on the individual patient and individual allergies
need to consider what has this pet NOT been exposed to previously
Cross-reactivity can occur btw closely related species (chicken and duck) but possible non-related species (fish and mammals)

24
Q

Why might hydrolized proteins help in allergy diets?

A

Proteins broken down into smler fragments to evade the immune response
depending on the size of the protein pieces and the sensitivity of the pet, may or may not elicit an allergic reaction

25
Q

What are some other dietary considerations to keep in mind with allergy diets?

A

complete dietary hx necessary to determine what proteins pet has been exposed to previously
Trial should be performed for 8wks and diet fed exclusively
dietary challenge can be performed after positive response seen - add single protein source one at a time to see if pet will response
pos response to challenge indicates a protein the pet is sensitive to
no response to challenge indicates a safe protein
helps determine potential long-term feeding option

26
Q

What is atopy?

A

hypersensitivity of immune system to allergens in the enviro - pollen, fleas, cleaners, plants
Clin signs often seasonal and associated w/ seasonal allergens, can be year round if allergen year round (dust mites
Typical signs associated w/ skin but can affect resp and GI systems
includes a weakened skin barrier which inc water loss and access of allergens
Goal: improve skin health and reduce clinical signs of skin dz and enviro allergies

27
Q

WHat are the nutritional priorities of atopy diets?

A

high digestibile protein w/ appropriate AA profile - 30% of dietary protein goes to support skin and coat, heals skin and regrow hair coat
Healthy fats - maintains healthy skin barrier, reduces evaporation of water from the skin (less itching from dry skin), reduces ability to environmental allergen to be absorbed thru skin
EPA and DHA to reduce inflam, omega3’s from fish oil to improve pruritus and inflam better than omega 3s from mineral or fax seed oil
B vitamins and histidine - improve ceremid prod and dec transeipidermal tater loss, improve skin barrier, dec permeability of skin to allergens
Glycrrhizin (licorice root extract) immunomodulating effect (dec activation of Th 2 IL4

28
Q

What other considerations do we need to take into account with multimodal management?

A

topical therapies, shampoos, immunotherapy, medications, allergen avoidance
Possible concurrent cAFR - voel protein source

29
Q

What are GI conditions?

A

wide variety, tx not always the same
consider whether pet needs fat reduction, fibre modification, hydrolyzed or novel protein (non-cutaneous adverse food reaction)

30
Q

What are the goals of GI condition diets?

A

supports GIT, minimize irritation, promote emptying, normalize motility, address symptoms - V/D, constipation, weight loss

31
Q

What are the nutritional priorities of GI condition diets?

A

Highly digestible protein - novel or hydrolyzed protein source if food reaction suspected
Lower fat - aids in passage of food, necessary in fat-responsive conditions (canine pancreatitis) cats quite fat-tolerant
Supplemented elytes
Fibre to help regular motility: addresses colitis and consitpation
Highly digestible carb sources
prebiotics to support healthy GIT microbiota

32
Q

Why might chicen and rice be recommended for GI diets?

A

It is a bland option for acute GI conditions

33
Q

What might we consider with Gi condition diets?

A

consider foood volume neds - post sx may require smaller food volumes that are higher in calories
sm, frequent feedings to avoid overloading the GIT
prebiotic fibre to feed the enterocytes
Avoid repeated dietary changes - allow 3-6wks for the microbiome to adjust to the new diet

34
Q

Why might a patient have liver dz?

A

liver aids in digestion, removal of waste products and prod of molecules and substances necessary for bodily function
Many diff conditions that can affect the liver: a dx is not made (ex. elevated liver enzymes)
Need to consider the degree of dz, age of onset and specific condition - PSS or MVD typically present in very yg dogs
Copper storage dz - genetic mutation related to copper excretion, can occur in bedlington terriers, labs, dalmations = excess copper build up in liver

35
Q

What are the goals of liver dz diets?

A

provides an appropriate amount of protein
in cases of PSS or MVD, lower protein recommended
However low protein can result in muscle wasting
hepatic encephalopathy can be worsened when muscle muss is low since ammonia is metabolized by liver
vegetable based proteins tend to be lower in purine which lower the metabolic demand on the liver
moderate sodium levels - mgmt of portal hypertension
Restricted copper lvls - when necessaryW

36
Q

What is the purpose of milk thistle

A

contains pharmaceutical compound silymarin - a liver protectant
used in liver dz, cancer patients, patients who are on chronic drug therapies w/ adverse liver effects - such as phenobarbital or steroids
There is a wide therapeutic range (Mg/kg) and has few adverse effects

37
Q

Why might renal dz occur?

A

Kidney dysfunction results in build up of waste products and loss of concentrating ability of the kidneys
Kidney disease is diagnosed and staged based on evaluation of various lab tests (creatinine, USG, proteinuria, SMDA etc)
staging is important to understand
generally, nutritional recommendations are broken down into early renal (1-2 in dogs, 1 in cats) and advanced renal (stage 3-4 in dogs, 2-4 in cats)

38
Q

What are the goals of renal disease diets?

A

slow down the progression of renal disease - no diet can stop it
support energy requirements
maintain lean muscle mass
support hydration

39
Q

How does protein play a role in renal disease?

A

high lvls of dietary protein were hx’ly linked to faster progression of experimentally induced kidney dz in cats
Lower protein diets recommended to manage chronic renal insufficiency
High protein intake hasn’t been noted to advance development of CKD in healthy pets

40
Q

How might phosporus play a role in renal disease diets?

A

dietary phosphorus restriction key to help slow down dz progression
Most of phosphorus from the ingredients comes from the protein source
Protein restriction in renal disease = phosphorus restriction

41
Q

What are the nutritonal priorities of early renal disease diets

A

high quality protein (mitigate muscle loss)
Moderate phosphorus restriction (below AAFCO minimum not necessary at this time)
Omega 3 FA (Anti-inflam, improve blood flow to kidney)
Antioxidant (Vit E and C, b-carotene)

42
Q

What are the nutritional priorities of advanced renal disease diets?

A

low protein (mitigate urea and creatinine build up)
low phosphorus (highest link to longevity)
Low Na (mitigate hypertension)
Omega3FA (anti-inflam, improve blood flow to kidneys)

43
Q

What are some other considerations of renal disease diets?

A

diet transitions in advances stages are SLOW (like wks)
need to consider nausea and malaise that may affect appetite
ensure adequate hydration (SQ or IV)
ensure energy needs met - feeding tubes in advanced stages

44
Q

Why might animals have hyperthryoidism?

A

An excess of thyroid hormone prod = inc metab rate that causes weight loss, polyphagia, restlessness, aggression, ngith wandering, vocalization
Common in older cats >12yrs
Some enviro risk factors: some pollutants, have hypothesized to be a predisposition

45
Q

Which pet food brand has th eonly hyperthyroid diet?

A

hill’s - limited iodine intake to control T4 prod, L-carnitine to maintain muscle mass, feed exclusively
Good to use when there are no concurrent health conditions needed nutritional mgmt, and when other tx not possible

46
Q

Why might urinary tract dz happen/

A

urine is not just water
also contains minerals and mineral precursors
Genetic predispositions and lifestyle factors can increase the risk of certain minerals accumulating to form crystals or uroliths (stones)
Risk factors include: obesity, stress, diet, breed, water intake

47
Q

What are the most common types of stones?

A

struvite: in dogs(almost always 2nd to UTI) in cats (multifactorial cause)
Calcium oxalate (genetic disposition, medical conditions resulting in hypercalcemia)

48
Q

What are the goals of urinary tract dz diets?

A

inc urine volume - typically by inc water intake, results in lower USG
dissolve struvite crystals/uroliths - Ca-Ox cannot be dissolved, must be removed
creat urinary enviro less favorable to development of crystals/stones

49
Q

What are the nutritional priorities of urinary tract disease diets

A

controlled lvls of mangnesium and phosphate (struvite)
Controlled lvls of calcium (ca-ox)
Acidifying (struvite)
Alkalinizing (Calcium oxalate)
Additionally, can manage concurrent conditions like stress and obesity

50
Q

What are some other considerations with urinary tract disease diets?

A

encourage water intake with fresh water, alt water types (still or filtered), alt watering methods (fountain, bowl, tap), alt receptables (bowl size, shape, depth)
Small frequent feedings
Provide opportunities to urinate

51
Q

What is dental disease, how might size, breed, age, anatomy, lifestyle and disease affect it?

A

size - small breeds
breed - greyhouse, basset hounds, boxers
Age - inc w/ age
Anatomy - brachycephalcs, retained deciduous teeth
Lifestyle - hard chews
dz - felk, FIV, certain meds

52
Q

How can we slow down the progression?

A

COHAT, brushing, chews/treats/diets
look for VOHC (veterinary oral health council) label

53
Q

What is the difference btw kibble and canned dental dz diets?

A

crunching action of dry should clean teeth, have less residue
Many kibbles shatter with chewing, no mechanical cleaning
Size, shape and texture of kibble can have pos effect, dietary fibre can affect plaque and tartar formation - really only benefits chewing teeth

54
Q

What do dental diets do?

A

promote chewing and full contact with teeth - texture, shape and size
prevent the mineralization of plaque to tartar - calcium chelators, limited calcium lvls
Antioxidants to reduce oxidative stress

55
Q

How are chews useful in dental disease?

A

plain treats and chew toys have not been shown to have benefit
Dental chews (+/- chlorhexidine or brown algae) can have benefits

56
Q

What are the risks of dental chews?

A

esophageal FB obstruction
tongue entrapment
high calories so weight gain
nutritional imbalances if fed excessive treats
GI upset
Fractures from very hard chews (antlers, hooves, nylon bones) - should be able to dent chew with a fingernail