CCM: Nutrition 124-127 Flashcards
What are the levels of the muscle condition scoring system? What animal is this system validated in?
Four levels
1 - normal muscle mass 4 - severe muscle loss
assessed mainly by palpating the paralumbar muscles
List 5 indications for nutritional support/intervention in the ICU
- anorexia for 3+ days
- hyporexia for 10+ days
- 10% BW loss
- low BCS
- moderate to severe muscle atrophy
What is the terminology for muscle loss from age versus disease?
cachexia - disease induced
sarcopenia - age-related
List the 3 groups of antioxidants and examples for each
- proteins - e.g., albumin, haptoglobin, ceruloplasmin
- enzymes - e.g., superoxide dismutase, glutathione peroxidase, catalase
- non-enzymatic/small molecules - e.g., vitamin C, vitamin E, glutathione, selenium, lycopene, beta-carotene
What are the 3 main functions of arginine
- precursor of nitric oxide
- cell growth and proliferation (polyamine synthesis)
- wound healing (proline synthesis)
Describe how critically ill versus healthy but fasting animals differ in their source of products for gluconeogenesis
illness –> protein breakdown and AA used for gluconeogenesis predominates
fasting but healthy –> lipid and glycogen stores prioritized for breakdown
What is the current recommendation for the length of anorexia in days, on when to start nutritional intervention (i.e., feeding tube)
5 days
When should enteral nutrition be supplemented with parenteral nutrition
if < 50% intake achieved by voluntary intake
What should be addressed before nutritional support is implemented?
hydration status
cardiovascular instability
electrolyte disorders
acid-base disorders
What is the recommendation for protein intake for dogs versus cats when initiating enteral nutrition in the hospital?
dogs 5-6 g/100 calories
cats 6-8g/100 calories
List the typical duration of, advantages of, and disadvantages of a NG or NE tube
less than 5 days
advantages: cheap and easy to place, minimally invasive, no anesthesia required
disadvantages: liquid diet only, no gruel, dislodgement possible, obstruction common
List the typical duration of, advantages of, and disadvantages of an E-tube
weeks to months
advantages: cheap and easy to place, gruel diet can be fed
disadvantages: needs GA, invasive, tube site infection or inflammation, obstruction possible
List the typical duration of, advantages of, and disadvantages of a G-tube
weeks to months
advantages: gruel diet can be fed
disadvantages: dislodgement may lead to peritonitis, GA needed, special equipment for PEG
List the typical duration of, advantages of, and disadvantages of a J-tube
weeks
advantages: bypasses most of the upper GI
disadvantages: dislodgement may lead to peritonitis, GA needed, laparotomy needed, can only feed a complete liquid diet
what is the maximum volume of food that can be fed per feeding
10 mL/kg
What is major concern if giving parenteral nutrition with a too high osmolarity?
thrombophlebitis
What is the caloric density and osmolarity of 8.5% amino acids?
0.34 kcal/mL, 880 mOsm/L
What is the recommendation for protein feeding amounts for parenteral nutrition?
4-6 g/100kcal (dog)
6-8 g/100kcal (cat)
What is the caloric density and osmolarity of 50% dextrose
1.7 kcal/mL
2500 mOsm/L
How much of the calorie intake should be provided by dextrose in parenteral nutrition?
half of the non-protein calories
What is the caloric density and osmolarity of a 20% lipid emulsion?
2 kcal/mL
260 mOsm/L
What is the typically recommended daily dose of lipids in parenteral nutrition? Why is this amount limited?
maximum of 2 g/kg/day
concern for side effects such as thrombophlebitis, hyperlipidemia/triglyceridemia, exaggerated inflammatory response, lipid embolization, microbial contamination
What size filter should be used for parenteral nutrition administration?
1.2 micrometer
