Exam 1: Lecture 4: Nutritional Assessment and Energy Calculations Flashcards
What vital signs should be taken on a patient?
- Temperature
- Pulse
- Respiration
- Pain
- Nutritional assessment
What 4 steps should be used during a nutritional assessment?
- Assess the patient
- Assess the current + prior diet
- Assess the feeding management
- Repeat as needed
Should pt weight be taken in lbs or kg?
kg
If a pt weight is given in lbs, how do I get that to kgs?
divide weight in pounds (lb) by 2.2
T/F: Record BW only at sick visits
FALSE!!
record BW at every visit and recheck
- If hospitilized, weigh patient daily to monitor trends in weight and hydration
T/F: BCS is a subjective evaluation / measurement of body fat mass
true
T/F: The 5 point scale is preferred for BCS evaluation
false, we use the 9 point scale
What is the ideal BCS for Dogs
5/9
What is the ideal BCS for cats
5/9
T/F: BCS is not validated for growing puppies and kittens
true
Does the following details suggest under ideal, ideal or over ideal BCS?
- Ribs, lumbar vertebrae, pelvic bones and all bony priminances evident from a distance. no discernable body fat. Obvious loss of muscle mass
- Ribs, lumbar vertebrae and pelvic bones easily visible of other boney priminences. Minimal loss of muscle mass
- Ribs easily palpable and may be visible with no palpable fat. tops of vetebrae visible. Pelvic bones becoming prominent. obvious waist and abdominal tuck
under ideal
Does the following details suggest under ideal, ideal or over ideal BCS?
- RIbs easily palpable, with minmal fat covering, waist easily noted, viewed from above. abdominal tuck evident
- ribs palpable without excess fat covering. Waist observed behind ribs from above. Abdomen tucked up when viewed from the side
ideal
Does the following details suggest under ideal, ideal or over ideal BCS?
- Ribs palpable with slight excess fat covering. wasit is viewed from above but its not prominant. Abdominal tuck is not apparent
- Ribs palpable with difficulty; heavy fat cover. Noticable deposits over lumbar area and base of tail. Wasit barely visible. Abdominal tuck may be present
Over ideal
Each 1 point change (1-9) is estimated at _____% loss of body weight and ____% fat mass
10%
5%
T/F: the ideal BCS is 5/9 which is 0% excess weight and a good current weight
true
BCS is 3, what is % excess weight and how do I calculate target body weight
BCS 3
-20% excess weight
Target BW = current BW / 0.8
BCS is 8, what is % excess weight and how do I calculate target body weight
BCS 8
+30% excess weight
Target BW = current BW / 1.3
A dog weighs 30 kg and has a BCS of 7/9. What is target BW?
Target BCS 5/9
So need to lose 2 BCS I.e. 120% of ideal BW
30kg / 1.2 =25 kg
A cat weighs 3.5 kg and has a BCS of 2/9. What is the target BW?
5/9 is ideal
3.5/0.7 = 5 kg
T/F: Muscle condition scoreing is a subjective evaluation/measurement of body muscle mass
true
What are the 4 options for muscle condion scoring?
Normal (3/3)
Mild muscle loss (2/3)
Moderate muscle loss (1/3)
Severe muscle loss (0/3)
What is muscle condition scoring used to identify?
Cachexia and sarcopenia
What are different stages of a patients lifestyle?
- Adult maintenance
- Pregnant / gestation
- Lactation
- Growing
- Working / performance
How do we know the patient is healthy?
- bright and alert
- good appetite
- healthy BCS and MCS
- skin not dry and flaky, no skin lesions and shiny coat
- normal lymph nodes
- eyes unremarkable
- formed stool, passed without difficulty
- good urine and no problem
- absence of lab parameters
Nutrient requirement may be expressed as?
- Absolute amount
- Diet concentration on a dry matter (DM) or as fed (AF) basis
- Diet concentration on a caloric basis
What are common things dogs and cats are fed?
- Water (most important)
- COmmercial pet food, homemade diet, or combination
- Commercial treats
- Fresh or cooked treats, table scraps
- Supplements
- Flavored medications
- Toothpaste
When taking a diet history what do you start with?
open ended questions
EX: describe or walk me through it
After asking open ended questions when taking a diet history what should be asked during the close ended questions
- Food/treats/other brans
- Food/treat/other formula (s) flavors
- Amount(s)
- how they are measured
- How do you feed
What questions should be asked when measuring food?
- is a proper measuring device used for volumes
- What is a cup
T/F: 1 fluid ounce equals 1 ounce weight
FALSE!!
1 fluid ounce does NOT equal 1 ounce weight
What is the most precise way to feed animals, but is not commonly practiced?
Feeding by weight is the most precise
What are ways food is offered to pets?
- Bowl
- trough
- ground
- pet food/treat toy/puzzle
What questions do we need to ask if there is more than 1 pet in the household?
- Are multiple animals fed together
- Do all animals have equal access
What questions do we need to ask related to how often food is offered?
- Once per day vs twice a day vs more frequent
- Is is more important to mimimize time between meals? (Depends on the animal and the circumstance, such as puppies)
What questions should be asked when seleting a pet food
- is it safe?
- is it nutritious?
- Is it appropriate for this pet?
When asked if the food we are selecting is safe, are we confident that the manfacture has appropiate quality and food safety procedures to avoid ……….?
- bacteria
- mycotoxins
- pesticides, herbicides
- Heavy metals
- Contaminats
When deciding is a pet food is nutritious we ask are we confident that the diet is complete and balanced. How can we ask this?
- All required nutrients present at appropriate amounts
- Nutrient levels tested in raw materials and finished products
- Digestability testing
- Feeding trials
When asking if the feed is appropiate for pets, how do we ensure this?
- Nutrition assessment
- Especially patient assessment
What are the two categories for AAFCO nutrient profile guidelines?
- Growth and reproduction
- Maintenance
WSAVA guidelines are helpful for clinicians to check on patients pet food selection. What questions can we ask WSAVA pet food company?
- Do they employ a nutritionist
- Who formulates the diet
- What is the quality control procoess for ingredients and finished prducts
- Will they provide information on requested nutrients
- What kind of product research or nutrition studies have been conducted? Is it published in peer-reviewed journals
Besides the WSAVA guidlines/company, who else should be able to answer questions regarding pet food selection?
- Veternarians
- Veterinary speacilist (nutritionists)
- Breeders
- Show owners and handlers
- Lots of opinions are out there (opinions are not always rooted in scientific evidence)
How can we see if the recommended diet and feed management is appropriate?
- Is the pt maintaing health BCS, MCS, attitude, activity, etcs.
- If so, no change is needed
- If not, adjust
Whatare the 3 formuals to estimate energy requirements (expenditure)
- Basal energy requirements (BER)
- Resting energy requirements (RER)
- Daily energy requirements (DER)
What energy requirement (expenditure) is desribed as?
- calories to keep the pet only for a low/normal energy
Basal energy requirement (BER)
What energy requirement (expenditure) is desribed as?
- expressed as Kcal metabolizable energy (ME) per day
- the foundation to which lifestage factor (aka. daily energy requirement factor) is mutliplied to estimate ….
Resting energy requirement (RER)
What energy requirement (expenditure) is desribed as?
- DER for adult maintenance aka. Maintenance energy requirement (MER)
- DER for growth
- DER for work
- expressed as kcal metabolizable energy (ME) per day
Daily energy requirement (DER)
Define gross energy
food energy (burnt in bomb calorimeter)
Define Digestible energy
gross energy - fecal energy (burn food and poop)
Define metabolizable energy
digestible energy - urine & gas energy
(this is how the energy contents of pet food is expressed)
How are the energy contents of pet food expressed?
Metabolizable energy
Define net energy
metabolizable energy - heat increment (energy lost as heat)
How is metabolizable energy (ME) determined?
- by feeding test or by calculation
Is lipids, proteins, or carbohydrates the most atwater factor and modified atwater factors in human and pet food?
lipids
What is the equation for resting energy requirement (RER) equation
RER = BW(kg) ^ 0.75 x 70
What are the RER units measured in?
kcal/day
T/F: Energy requirements are NOT linear
true
T/F: A mouse needs around 18x more energy per BW than an elephant does due to surface area touching the ground?
true
Calculate RER for a 9 lb adult cat with a BCS of 59 and a normal MCS?
201.355 kcal/day
Calculate RER for a 20 kg adult dog with a BCS of 5/9 and normal MCS
20KG ^ 0.75 x 70 = 662.01 kcal/day
What is the equation for DER?
DER = RER x lifestage factor
For an adult neutered males, what is the lifestage factor for a dog and cat?
Dog: 1.4 to 1.6
Cat: 1.2 to 1.4
Calculate the DER for this dog
DER = RER x lifestage factor
DER = 937.78 kcal/day x 1.5 (Avg)
DER = 1406. 68
Calculate the DER for this cat
DER = 992.89
Lifestage factor provides an estimate of?
patients daily energy requirement (DER)
