Dietetics of pancreas disease (dogs and cats) Flashcards
What is the nutritional objective for Pancreatic insufficiency that is NOT exocrine
Decr intestinal load
Avoid clinical signs
Replace the digestive enzymes
What is NPO
NIL PER OS
When there is serious, massive vomitting, that may have been caused by acute, slight enteritis, acute gastritis or pancreatitis
Aim to rehydrate and stop the vomitting
Max for 24-48 hrs
The nutrient content of prescription diets and the type of diet
- Incr or normal CP, make it highly digestible (so low residue) and HBV
- Decr fibre to <2%
- Decr fat to <10%
- Supplements and Additives: digestive enzymes, fat soluble vits, prebiotics, DHA and EPA
* *small meals more often, canned or soaked dry food
Exocrine role of the pancreas
1) acinar cells:
digestive enzymes- lipase, amylase and trypsin
Inactive proenzymes/zymogens: trypsinogen, proelastase and phospholipase
2) duct cells:
Bicarbonate to buffer gastric content
Intrinsic factor for Cobalamin/B12 abs
Colipase: is a cofactor for lipase
Endocrine function of the pancreas
Langerhans islet cells secrete insulin and glucagon
Regulate BG levels
What is the starch digesting enzyme and the endproduct
Amylase and endproduct is Maltose
What are the protein digesting enzymes and the endproducts
Peptidase, Chymotrypsin, Trypsin, Carboxypeptidase, Nucleotidase, Nucleosidase, Nuclease
Oligopeptides, dipeptides, Aa’s, nucleoside, phosphate
What enzyme digests fat and what are the endproducts
Lipase
FFA’s, glycerol and mono-diglyceride
Acute pancreatitis and treatment
Dogs more so than cats Multiple etiology NPO (even water) for 3-5 days Incr carbs, decr fats Give 3-5 meals per day
EPI what it is and progression
Congenital in dogs: autosomal rec in GS and rough coated collies, rare in cats
Insufficient digestive enxyme production in the pancreas (only 10%) or obstruction of the pancreatic duct by e.g tumour
Chronic necrotic/atrophic damage by autominnume or virus Leads to maldigestion (feed not properly broken down) and malabs (the nutrients are not passing to the blood or lymphatics)
Clinical signs of EPI (7)
- Decr BW despite normal appetite and feed intake
- Osmotically active ingesta– water influx then chronic Dx
- Coprophagy
- vit def- skin and fur, mild anaemia
- Faeces- high vol, pale, undigested fat
- IDDM can develop
- Small bowel disease can develop because of the bact overgrowth
Lab findings to diagnose EPI
- TLI of canine serum: conc is less than or equal to 2.5mcg/L
- Faecal elastase test- ELISA
- Faecal smear and staining to detect the undigested feed particles: GIEMSA for straited muscle, LUGOL for starch, SUDAN for lipid droplets
Nutritional treatment of EPI (6)
- Make it highly digestible
- Decr fat- this may cause def in fat soluble vits and PUFA’s
- Low fibre
- Moderate level of HBV protein
- Supplement the digestive enzymes lifelong! Dipankrin in intestinal solvent capsule, or give fresh bovine pancreas in every meal
- Incr feeding intervals to 4x a day, but smaller amounts
Causes of acute pancreatitis (5)
- Medications
- Infections
- Obesity
- Trauma
- Shock
What are the symptoms of acute pancreatitis?
- Abd distension
- Lack of appetite
- Vomiting
- Dehydration
- Yellow greasy stools
- Depression