Clinical nutrition in disease mmanagement Flashcards

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1
Q

What can high fat diets trigger?

A

acute pancreatitis

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2
Q

Use - diets high in omega 3 FAs

A

attenuate inflammatory conditions (OA)

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3
Q

Do pet foods need a licence?

A

No - prescription diets, nutritional supplements don’t have to demonstrate efficacy to a regulatory agency. If a pet food manufacturer makes a claim, they must substantiate a claim but need not obtain license to sell food for the specific condition.

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4
Q

What are diet recommendations based on?

A

on certain features of the diet - e.g. high fibre, low fat.

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5
Q

What is difficult in modern vet medicine?

A

many animals living longer with multiple medical conditions with conflicting ‘preferable’ dietary components.

  • multi-pet households.
  • to simplify:
    1. ) differentiate b/w actual diet effects from company claims
    2. ) don’t exacerbate one condition with tx of another
    3. ) if no ‘ideal’ diet exists then prioritise
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6
Q

Factors affecting client compliance

A
  • ability to purchase diet
  • views on commercial diets
  • abilit to carry out nutritional plan (obesity in multi-pet house)
  • practice related factors (e.g. only one brand)
  • sometimes no ideal diet –> therapeutic home-made diet
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7
Q

Describe formulating a home-made diet

A
  • technically difficult for long-term cases
  • all macronutrients (protein, fat, carbohydrate, energy) and micronutrients (minerals, trace metals, vitamins) very difficult to achieve without correct supplementation
  • expensie service at referral
  • Meat only iet: low Ca, high phosphorous (unbalanced, esp for growing animals)
  • not easy to prepare, time-consuming
  • some clients may want to improvise with the recipes –> unbalanced
  • risk of being no better than a commercial diet
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8
Q

Diets for liver disease

A
  • protein restricted
  • copper restricted
  • na restricted
  • ajusted branched to aromatic aas
  • fortified with vitamin K
  • fiber
  • l-carnitine
  • but NOT all liver diseases benefit from these dietary adjustments !!!
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9
Q

Systematic approach for formulating a nutritional plan

A
  1. list working diagnoses
  2. determine which diagnoses are amenable to dietary interventions
  3. prioritise conditions requiring more pressing attention
  4. list ‘nutrients of interest’ for each diet
  5. list other nutritional considerations or factors for patient/client
  6. determine if conflicts of interest for different conditions
  7. prioritise factors in decreasing order of importance
  8. determine a commercial diet that satisfies the most identified factors and if not consider home-made diets
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10
Q

USE - reduced sodium

A
  • sometimes heart disease (esp CHF)
  • v controversial
  • major problem is that it reduces palatability
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11
Q

Use - reduced protein diet

A
  • advanced kidney dz
  • advanced liver dz associated with HE
  • PLN
  • sometimes these diets are high fat to make up calories
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12
Q

Use - reduced phosphorous

A
  • advanced CKD
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13
Q

Use - reduced fat diet

A
  • wt loss
  • pancreatitis
  • GI malabsorptive conditions
  • commonly these diets are combined with high fibre (dilutes calories)
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14
Q

Uses - high fibre diets

A
  • GI diseases

(esp large bowel problems like colitis, constipation)

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15
Q

Use - reduced calorie diets

A
  • mainly for wt loss plans
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16
Q

When are diets employed for CKD?

A

unless azotaemia is pathological you may not require reduced protein diets - renal diets usually introduced at IRIS stage 2

17
Q

Outline the balance in reducing salt intake for CHF

A
  • overall decrease Na a moderate amount as will help to decrease water retention
  • excessively decreased Na –> unpalatable and causes increased aldosterone –> worsens CHF
18
Q

Does IBD always benefit from a diet/

A

Not always as the cause is not always a hypersensitivity problem

19
Q

Which is prioritised when formulating a diet for animal with IBD and a hx of urethral obstruction

A

prioritise IBD as V, D, wt loss but consider urolithiasis too as this can be life-threatening. Overall:

  1. novel protein source
  2. increase water intake
20
Q

Briefly outline diet for colitis

A
  • decrease fat

- increase fibre (remember different types of fibre: soluble vs insoluble and fermentable vs non-fermentable)

21
Q

With increased liver enzymes, what diet is necessary?

A

no need to adjust diet based on this alone. If HE signs as well –> restrict protein

22
Q

Uses - diets

A
  • decrease dz risk
  • decrease SC severity
  • reverse condition (unusual)
  • manage condition (usually)
  • alter dz progression