Digestion & Metabolism 2: SA Therapeutic Nutrition Flashcards
GOAL of dietary therapy? (1 overall, 2 subs)
MORE organ dysfunction = restriction of ____ nutrients
= to provide NUTRITIONALLY ADEQUATE DIET that…
1. MAXIMIZES NUTRIENT ABSORPTION
2. REDUCES INFLAMMATION
MORE organ dysfunction = restriction of ESSENTIAL nutrients
how can we feed a diet that is MAXIMALLY ABSORBED?
feed a diet that’s HIGHLY DIGESTIBLE!
3 benefits of INCREASING digestibility of diets?
- CHRONICALLY SICK patients have HIGHER LIKELIHOOD of absorbing ADEQUATE NUTRIENTS/CALORIES
- DECREASED chance of OSMOTIC D+ due to SEMI-DIGESTED contents sitting in lumen
- DECREASED chance of ANTIGENIC STIMULATION causing DIETARY HYPERSENSITIVITY
5 factors AFFECTING diet digestibility…
hints: SMALLER, PROTEINS, POSITIVE effect on DIGESTIBILITY
- PATIENT’S GI FUNCTION
- MEAL SIZE = SMALLER & FREQUENT IS BETTER
- SOURCE and QUALITY of nutrients, especially PROTEINS
- FIBER; INSOLUBLE fibers DECREASE DIGESTIBILITY
- PROCESSING = can have POSITIVE effects on DIGESTIBILITY
ANIMAL protein has ___ digestibility, while PLANT protein has ____ digestibility
VARIABLE, UNIFORM
in a HIGHLY digestible diet, the AMOUNT of FAT is ____-____
LOW- MODERATE
why?
–> DIGESTION & ABSORPTION of fat is VERY COMPLEX
if an animal CANNOT absorb fat properly, what 3 things are they missing out on?
- CALORIES
- FAT-SOLUBLE VITAMINS
- ESSENTIAL FATTY ACIDS
INSOLUBLE fiber…
main example in PET FOODS?
___-forming
____ GI TRANSIT TIME
has ____ fermentability
main example = CELLULOSE
BULK-FORMING
DECREASES GI TRANSIT TIME
has LOW fermentability
SOLUBLE FIBERS…
2 examples?
_____-forming
can ____ GASTRIC EMPTYING
___ fermentability
2 examples?
1. GUMS
2. PECTIN
GEL-forming
can SLOW GASTRIC EMPTYING
HIGH FERMENTABILITY
DIETARY HYPERSENSITIVITY….
can be involved in perpetuating WHAT disease?
what can this cause the GUT to become? why?
can be involved with IBD
can cause GUT to become INCREASINGLY PERMEABLE in MUCOSA due to INFLAMMATION
if an animal has IDIOPATHIC INFLAMMATORY BOWEL DZ, what 2 kinds of diets can we put them on?
which one tends to be more EFFECTIVE?
how SOON do we tend to see RESOLUTION of clinical signs if caused by DIETARY HYPERSENSITIVITY? (range)
2 diets?
1. HYDROLYZED –> MORE EFFECTIVE
2. NOVEL PROTEIN LIMITED-ANTIGEN
how SOON? = within 1-2 WEEKS if dietary hypersensitivity
5 traits in diet for animals with GI DZ?
- NUTRITIONALLY-BALANCED
- PALATABLE
- CONVENIENT
- HIGHLY DIGESTIBLE
- LOW-MODERATE FAT
CANINE PANCREATITIS…
chronicity?
2 clinical signs?
NPO until patient RESOLVES clinical signs?
what diet/when is best?
usually ACUTE
2 clinical signs?
1. V+
2. ABDOMINAL PAIN
NOT NECESSARY
should do EARLY ENTERAL NUTRITION
MEDIUM CHAIN TRIGLYCERIDES used mostly in ____ > ____
DOGS > CATS
FELINE PANCREATITIS…
present with WHAT 2 clinical signs?
associated with WHAT 2 diseases?
these patients require ____ SUPPORT
2 clinical signs?
1. ANOREXIA
2. WEIGHT LOSS
associated with…
1. IBD
2. HEPATIC DZ
these patients require NUTRITIONAL SUPPORT
3 roles of NUTRITION in managing LIVER DZ?
- MAINTENANCE of NORMAL METABOLISM
- avoid TOXIC BY-PRODUCT ACCUMULATION
- provides substances that HELP with HEPATOCELLULAR REPAIR & REGENERATION
animals with HEPATIC dz often show WHAT clinical sign?
NAUSEA/VOMITING
HEPATOBILIARY FUNCTIONS related to NUTRITION (5)
- METABOLISM of CARBS, FAT & PROTEIN
- PROTEIN SYNTHESIS
- BILE SYNTHESIS & SECRETION (fat assimilation)
- STORAGE of ENERGY, VITAMINS & MINERAL
- ENDOCRINE FUNCTION
3 CLINICAL signs related to NUTRITION & HEPATIC DZ?
& where these signs ORIGINATE from
- HYPOREXIA (can be from FOOD AVERSION if forced)
- ENCEPHALOPATHY (can be from PORTOSYSTEMIC SHUNT)
- COAGULOPATHY (clotting factors not made in enough quantity)
CBC/chem findings for LIVER DZ… (6)
- INCREASED PT/PTT
- INCREASED BLOOD AMMONIA
- INCREASED SERUM BILE ACIDS
- DECREASED BUN
- HYPOCHOLESTEROLEMIA
- HYPOALBUMINEMIA
HEPATIC ENCEPHALOPATHY…
associated with either… (two)
what can CAUSE this?
associated with either…
1. HEPATIC INSUFFICIENCY (liver NOT synthesizing what it should)
2. PORTOSYSTEMIC SHUNT (substances from GUT that are NORMALLY CLEARED BY LIVER can ENTER SYSTEMIC like AMMONIA)
DIETARY EXCESS OF PROTEIN CAN CAUSE THIS!
what should we DO for DIETS if evidence of HEPATIC DZ?
how can we do this in diets? (3)
REDUCE DIETARY PROTEIN as much as possible (safely)
in diets…
1. HIGH digestibility even for a SMALL AMOUNT OF PROTEIN
2. PROPER AMINO ACID balance
3. JUST MEETS PROTEIN REQUIREMENTS but NOT GREATLY IN EXCESS
we should ONLY restrict protein if we see signs of…
what EXAMPLE of a diet has this?
INTOLERANCE
LIVER DIETS are RESTRICTED IN PROTEIN
ADEQUATE ___ ___ is ESSENTIAL to provide ___ of ENDOGENOUS tissues
CALORIC INTAKE, CATABOLISM
3 BENEFITS of INCREASING MEAL FREQUENCY?
- IMPROVED overall INTAKE (more likely to finish each meal)
- IMPROVED DIGESTIBILITY
- DECREASED manifestations of HEPATIC ENCEPHALOPATHY because of DECREASED PROTEIN EXPOSURE
