Nutrition for GI Disease, Pancreatitis, & Renal Disease

Question 1

What is a part of your assessment for a patient that is presenting for GI disease?

Answer 1

1. TPR
2. hydration status
3. fecal score, rectal, abdominal palpation
4. skin/coat exam
5. pain score
6. attitude and behavior
7. CBC/Chem: anemia, hypoalb
8. peripheral edema, ascites?
9. +/- cobalamin, folate, TLI, PLI, c/fPL, 25-hydroxy vitamin D
10. abdominal u/s or xray
11. canine chronic enteropathy activity index

Question 2

What is the management for GI problems caused by dietary indiscretion?

Answer 2

reduce or eliminate exposure

Question 3

what is the management for bilious vomiting syndrome?

Answer 3

Divide daily meals into 3-4 meals as opposed to 1-2

Question 4

What are dietary options for managing diarrhea?

Answer 4

1. highly digestible diet
2. fiber-enhanced diet
3. fat-restricted diet
4. hydrolyzed or NP diet
5. properly formulated homemade diet

Question 5

why is a highly digestible diet appropriate for acute diarrhea cases?

Answer 5

there will be more nutrients absorbed to meet the patients essential requirements

there will be less nutrients for microbes to ferment in the large intenstine

Question 6

T/F: using metronidazole for acute diarrhea is inappropriate and causes dysbiosis that can be long term

Answer 6

true

Question 7

T/F: environmental enrichment is considered another component of managing diarrhea

Answer 7

true because stress plays a role in abnormal stool (esp in cats)

Question 8

what are characteristics of large intestinal diarrhea?

Answer 8

increase urgency
increased frequency
straining
mucus
blood (hematochezia)

Question 9

what is the treatment for fiber-responsive large bowel diarrhea?

Answer 9

enhance dietary fiber
carbs with b-glycosidic bonds

Question 10

T/F: crude fiber represents total dietary fiber (TDF)

Answer 10

false – crude fiber underrepresents total dietary fiber (TDF)

Question 11

What are fiber supplements that can be added to diets for fiber-responsive diarrhea?

Answer 11

1. psyllium (metamucil, konsyl, now)
2. oligosaccharide prebiotics
3. cellulose

canned pumpkin and green beans also options but require larger volumes

Question 12

what is the treatment for constipation?

Answer 12

1. high fiber GI diet, weight loss diet, or psyllium enhanced diet (if fiber-responsive)
2. highly digestible core GI diet or wet diet (if non fiber responsive)
3. laxatives (insoluble fiber)
4. psyllium (soluble fiber)

Question 13

what are 2 non-fiber responsive chronic enteropathies?

Answer 13

food allergy
protein losing enteropathies

Question 14

How can you diagnose and treat hypoallergenic responsive diarrhea?

Answer 14

These patients usually are younger, have low canine chronic enteropathy activity indexes, and concurrent dermatologic issues.

treatment is hypoallergenic diet trial + rechallenge

Question 15

In order to use a novel protein for a hypoallergenic-responsive diet trial, what do you need first?

Answer 15

a thorough diet history

Question 16

What is the treatment for protein-losing enteropathies that cause diarrhea?

Answer 16

low-fat diet (lymphangiectasia)

low fat hydrolyzed diet (if lymphangiectasia + inflammatory enteropathy)

Question 17

how can you manage pancreatitis?

Answer 17

• eliminate access to items if it was caused by dietary indiscretion
• weight loss if overweight
• reduce fat
• ultra low fat vet commercial or homemade diet

Question 18

T/F: pancreatitis is typically primary in cats

Answer 18

false – secondary

you must manage the primary disease to control it, therefore a low-fat approach is typically NOT needed.

Question 19

why is the fat content in canned foods misleading?

Answer 19

they are typically lower in fat than commercial dry foods on an as-fed basis but not on a dry matter or kcal basis.

Question 20

what is the dietary treatment for EPI?

Answer 20

highly digestible diet (GI diet)

digestible enzymes mixed with the food

feed smaller meals more frequently.

Question 21

what is involved in the monitoring of GI cases?

Answer 21

1. GI improvement is expected within 2 weeks (or at least trending positively), if not consider a different dietary approach, more diagnostics, or medical management
2. check for weight gain and normal BCS and MCS
3. monitor appetite
4. monitor energy, behavior, and QOL
5. +/- monitor serum albumin, ascites, serum cobalamin and/or folate