Nutrition Flashcards
what is nutritional support?
method to support metabolic status of hospitalised patients
what are the advantages of enteral nutrition over parenteral?
easier
fewer complications
more economical
more physiological
why is malnutrition important in sick animals?
sick animals can’t compensate so the deficiencies are magnified (develops early in illness)
how should obese patients be treated in regards to nutritional support?
same as others
when does nutritional support need to be provided?
weight loss >10%
partial/complete anorexia >3 days
diseases causing excess catabolism
what are the four ways of providing enteral nutrition?
encourage feeding
force feeding (worst)
drugs
tube feeding
what are some drugs that can be used to encourage eating?
diazepam
mirtazapine (good in cats)
cyproheptadine
what are the four types of feeding tubes?
naso-oesophageal
oesophagostomy
gastrostomy (PEG)
enterostomy
how long can naso-oesophageal tubes be used for?
up to a week
what are the contraindications of naso-oesophageal tubes?
vomiting
no gag reflex
disease of nose/pharynx
how long can oesophagostomy tubes be used for?
couple of months
what are the contraindications of oesophagostomy tubes?
disease of oesophagus and below
what side is a gastrostomy tube placed on?
left flank
what its the minimum time a gastrostomy tube can be placed for?
7 days
what is the main disadvantage of an enterostomy tube?
needs constant feeding (no gastric reservoir)
what is the first stage of placing a naso-oesophageal tube?
place local anaesthetic down the nares
what direction should the naso-oesophageal tube be placed in?
ventromedially
how should the head be placed once the naso-oesophageal tube is in the nostril?
flex ventrally to allow tube to pass into the oesophagus
how can you know if the naso-oesophageal has entered the oesophagus?
patient swallows
draw back with empty syringe - should be a vacuum
flush with water (cough if in trachea)
how should a naso-oesophageal be attached to the patient?
through the middle of the face (between the eyes) using tape on tube and sutures
where is an oesophagostomy tube placed?
right/left lateral neck (best on left)
how are the carmalt forceps used to place an oesophagostomy tube?
insert them through the mouth and push out laterally then cut at this site
what is done once the forceps have been pushed out through the skin in placing an oesophagostomy tube?
pull tube out through mouth then redirect back down the oesophagus past the surgical site
what is done to check if an oesophagostomy tube is in the correct place?
xray
what does PEG tube stand for?
percutaneous endoscopically placed gastrostomy tube
how is a PEG tube placed?
needle into fundus and thread wire through, pull this out of the mouth using the endoscope, attach tube and pull it back through the fundus
what illness would the nutrition need to be slightly adjusted?
burns (losing lots of protein)
how long must you wait before feeding animals after gastrostomy or enterostomy tube placement?
24 hours
how much food should be fed on day 1, 2 and 3 of tube feeding?
1/3 (day 1)
2/3 (day 2)
3/3 (day 3)
what should always be done prior to feeding by a tube?
aspirate (see if anything from previous meal is left)
how often and fast should meals be administered by tube feeding?
5 times a day over several minutes (then flush with warm water)
when should tube feeding be stopped?
once voluntary intake >85% BER
what are some complications of feeding tubes?
blockage
GI upset
tube dislodgement (peritonitis)
stoma infection
what causes obesity?
positive energy balance (influenced by many factors)
how is the ideal weight of an animal worked out from a BCS?
each score over the ideal is 10% extra weight
is food intake or expenditure more important to weight loss?
controlling food intake is more effective that increasing expenditure
is what you feed or how much you feed more important to weight loss?
how much
what are the steps for calculating the energy intake a dog needs for weight loss?
estimate the ideal weight
calculate the maintenance energy requirements for the ideal weight
feed 60-80% of the maintenance of the ideal weight
how much of the maintenance energy requirement for the ideal weight should an entire male dog be fed?
80%
how much of the maintenance energy requirement for the ideal weight should an entire female dog be fed?
70%
how much of the maintenance energy requirement for the ideal weight should neutered female dog be fed?
60%
what are the steps for calculating the energy intake a cat needs for weight loss?
estimate the ideal weight
calculate the energy intake for ideal weight
what is a therapeutic diet?
diet formulated to help animals lose weight
what are the features of a therapeutic diet?
decreased energy content (low fat)
nutrients balanced for weight loss
lean tissue preservation
how can food be changed to reduce the intake?
increase water content
expand with air
change shape
increase protein/fibre
how can food be fed to increase weight loss?
(not in a bowl)
puzzle feeder
what are good alternatives to feeding treats?
vegetables with high water content
how often should patients receiving weight management be seen?
2-4 weeks (check and tailor diet/plan)
what diet is used for maintenance of weight loss?
therapeutic (slightly increase)
