B19. Dietetics of Pancreas Diseases (Dogs, Cats)

Question 1

Pancreas function

Answer 1

o Makes enzymes that break down sugars, fats and starches
o Helps the digestive system by making hormones

• Alpha cells- glucagon-
• Beta cells - Insulin

Question 2

Abnormal function/disease of the pancreas lead to

Answer 2

Malabsorption and maldigestion
o BW loss but normal appetite, vomitus, diarrhea
- Pale, foul smelling, loose, light coloured, fatty stool

Question 3

Types of pancreas diseases

Answer 3

EPI (exocrine pancreas insufficiency)
–> “Ugly but happy”
Acute pancreatitis
–> “Beautiful but depressesd”

Question 4

EPI

Pathophys

Answer 4

Decrease or absence of pancreatic enzymes
EPI occurs when the pancreas loses more than 90% of the ability to secrete the enzymes necessary for the digestion of luminal nutrients

Without proper digestion –> macronutrients do not get absorbed or digested –> Water loss in GI tract = diarrhea

Question 5

EPI

Clinical symptoms

Answer 5

Polyphagia but weight loss
Feces are in light brown color and have a foul smell
Undigested food particles in feces.  
May be dehydrated
Coat condition is poor

Question 6

EPI
And their reasons.
Dietary aid

Answer 6

Reduce intestinal load
Avoid the clinical signs
Digestive enzyme replacement

feces–> pasty and contain large amounts of fat (steatorrhea) (fat )

Question 7

EPI

Causes

Answer 7

Congenital pancreas hypoplasia
Inherited degenerative pancreas atrophy in the GSH
Severe pancreatitis

Question 8

EPI
Aim of feeding,
Nutritional management: characteristics of the diet, number of meals a day, physical form of the diet, supplements

Answer 8

After EPI has been confirmed dietary theraphy consist of providing highly digestible diet that is low In fat (<2g/100kcal) and fiber (<2% DM).

Fat malabsorption the fat soluable vitamins (A, D, E, K) and vitamin B12 may need to be provided parenterally

More frequent feeding and smaller meal enhances nutrient absorption
 Low fat
 Low fiber
 High vitamin (especially the fat-soluble vitamins and vit B12 cobalamin)
 CH should be high and easily digestible

Physical form of daily meals: canned food or soaked dry food

Question 9

Acute pancreatitis

Pathophys

Answer 9

Occurs when the pancreas becomes inflamed.

Question 10

Acute pancreatitis

Clinical symptoms

Answer 10

 Nausea, vomiting, fever, lethargy
 Painful distended abdomen
 Diarrhea and decreased appetite

Question 11

Acute pancreatitis

Causes

Answer 11

 A high fat diet
 Obesity
 Hypothyroidism
 DM

Question 12

Acute pancreatitis

Aim of feeding,

Answer 12

Goal: rest the pancreas – provide supportive care and control complications

Question 13

Nutritional management: characteristics of the diet, number of meals a day, physical form of the diet, supplements

Answer 13

 Small easily digestible meals
 High CH
 Low fat
 Feed given 3 -5 times (Every 2nd hour) a day

Physical form of daily meals: canned food or soaked dry food

Question 14

For mild pancreatitis

Answer 14

we provide fluid support and give nothing by mouth for at least 24 – 48 hours after the last period of vommeting. We then give small ammounts of water over 4 – 6 hours  If this is tolerated well – give small amount of low fat food divided over several meals/ day (four to six)

Question 15

For patients with severe pancreatitis,

Answer 15

nutritional support via enteral or parenteral route is considered. Allow the gut to rest and should be used for at least 5 days before the introduction of oral nutrition