Clinical nutrition in disease mmanagement Flashcards
What can high fat diets trigger?
acute pancreatitis
Use - diets high in omega 3 FAs
attenuate inflammatory conditions (OA)
Do pet foods need a licence?
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.
What are diet recommendations based on?
on certain features of the diet - e.g. high fibre, low fat.
What is difficult in modern vet medicine?
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
Factors affecting client compliance
- 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
Describe formulating a home-made diet
- 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
Diets for liver disease
- 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 !!!
Systematic approach for formulating a nutritional plan
- list working diagnoses
- determine which diagnoses are amenable to dietary interventions
- prioritise conditions requiring more pressing attention
- list ‘nutrients of interest’ for each diet
- list other nutritional considerations or factors for patient/client
- determine if conflicts of interest for different conditions
- prioritise factors in decreasing order of importance
- determine a commercial diet that satisfies the most identified factors and if not consider home-made diets
USE - reduced sodium
- sometimes heart disease (esp CHF)
- v controversial
- major problem is that it reduces palatability
Use - reduced protein diet
- advanced kidney dz
- advanced liver dz associated with HE
- PLN
- sometimes these diets are high fat to make up calories
Use - reduced phosphorous
- advanced CKD
Use - reduced fat diet
- wt loss
- pancreatitis
- GI malabsorptive conditions
- commonly these diets are combined with high fibre (dilutes calories)
Uses - high fibre diets
- GI diseases
(esp large bowel problems like colitis, constipation)
Use - reduced calorie diets
- mainly for wt loss plans
When are diets employed for CKD?
unless azotaemia is pathological you may not require reduced protein diets - renal diets usually introduced at IRIS stage 2
Outline the balance in reducing salt intake for CHF
- overall decrease Na a moderate amount as will help to decrease water retention
- excessively decreased Na –> unpalatable and causes increased aldosterone –> worsens CHF
Does IBD always benefit from a diet/
Not always as the cause is not always a hypersensitivity problem
Which is prioritised when formulating a diet for animal with IBD and a hx of urethral obstruction
prioritise IBD as V, D, wt loss but consider urolithiasis too as this can be life-threatening. Overall:
- novel protein source
- increase water intake
Briefly outline diet for colitis
- decrease fat
- increase fibre (remember different types of fibre: soluble vs insoluble and fermentable vs non-fermentable)
With increased liver enzymes, what diet is necessary?
no need to adjust diet based on this alone. If HE signs as well –> restrict protein
Uses - diets
- decrease dz risk
- decrease SC severity
- reverse condition (unusual)
- manage condition (usually)
- alter dz progression
