nutrition Flashcards
what are 3 major things to consider when looking at nutrition in disease management?
1) differentiate between actual diet effects from companies claims
2) dont exacerbate one condition with the treatment of another
3) if no ideal diet consists then prioritise
when may a home made diet be considered?
as a last resort
what is the 8 step systematic approach to figuring out a diet?
1) list working diagnoses
2) determine which are amenable to dietary intervention
3) prioritise conditions
4) list nutrients of interest for each disease
5) list other nutritional consideratiosn (e.g. compliance)
6) determine if any conflicts between nutrients
7) prioritise factors
8) determine a diet that can satisfy most factors
what would you limit sodium?
heart disease
what should sodium be restricted to?
less than 100 mg/100kcal
why may sodium normally be added to food?
to increase palatability
why may protein be restricted?
kidney failure
liver failure
allergy
protein-losing nephropathy
what should protein be restricted to?
Dog - under 5g/100kcal
Cat - under 7g/100kcal
what needs to be added to a low protein diet?
high fat to make up calories
when may phosphorus be restricted?
advanced kidney disease - puts greater strain on kidney and associated with worse prognosis
when should phosphorus never be restricted?
in growing animals
what should phosphorus be restricted to?
dog - under 140mg/100kcal
cat - under 150 mg/100kcal
why would fat be restricted?
weight loss
pancreatitis
GI malabsorption
what is done in low fat diets?
extra fibre added to dilute calories
what should fat be restricted to?
dog and cat - under 5g/100kcal
why would a high fibre diet be needed?
GI disease (esp large bowel)
how much fibre would be needed in a high fibre diet?
dog and cat - over 2g/100kcal
to lose weight what calories would you restrict to?
dog - under 300kcal/can or cup
cat - under 300 kcal/cup
cat - under 150 kcal/can
what are 2 things often targeted with diet to do with urolithiasis?
- diuresis for any urolith by increasing water intake
- changing urine pH to dissolve exsisting and preventative
how can struvite uroliths be managed by diet?
- diuresis
- calculolytic diets for about 1 month - make urine acidic to dissolve stones and reduce urine levels of urea,phosphorous and magnesium by being moderate in protein and highly digestible fibre
what is seen on an ECG with hyperkalaemia?
tented T waves
lack of p waves
widening complexes
bradycardia
how can diet help resolve calcium oxalate dihydrate uroliths?
these uroliths only form when the urine is supersaturated with these crystalloids so the diet controls excessive calcium and oxalate intake
-diuresis
what should not be dietary restricted in an animal with calcium oxalate uroliths?
-phosphorus as it can increase urinary calcium extcretion which contributes to the urolith formation
what is the dietary management of urate uroliths?
increase urine pH
lower urine concentrations of uric acid, ammonium and/or hydrogen ions
severe protein restriction to decrease purine
diuresis
what is the diet strategy for managing dogs with cystine uroliths?
- reducing cystine in urine by protein restriction
- increase solubility of cystine by alkalixing the diet
- Thiol-containing drugs as they react with cystine forming a more soluble complex
- diuresis
What is the diet for renal disease?
low protein low po4 restricted Na and K decrease need for urine acid secretion omega 3 FA high fibre calorie dense
why is protein restricted with renal disease?
minimise nitrogenous waste so relieves kidney workload
and reduces signs of uraemia
Do you still restrict protein with protein losing nephropathy?
yes as will reduce loss
-need good balance
what is the consequence of too low protein?
malnutrition
compromise renal function
muscle catabolism – azotaemia
why is phosphorus restricted in renal diets?
can improve prognosis
help prevent secondary renal hyperPTH
why is sodium often restricted in renal diets but why be careful with it?
- link with high bp causing renal disease in people
- in chronic PU they may be wasted so be needed
How is the acid/base status modified in renal diets?
want to decrease need for urinary acid secretion
what is the pH status of chronic kidney disease patients?
acidotic
what are the signs of acidosis?
anorexia naursea vom lethargy weakness muscle wasting wt loss
why is the caloric content of renal diets important?
most are often inappetant so higher caloric density will improve their nutrition
Why are renal diets substituted with omega 3 FA?
omega 3’s in the cell memebranes compared to omega 6’s mean less inflammatory leukotrienes and eicosanoids made
- this reduced infl may slow renal disease progression
why is high fibre important in renal disease?
fermented in colon and reduces pH which can trap ammonia so its excreted in the faeces instead of renally
