Nutrition for GI Disease, Pancreatitis, & Renal Disease Flashcards
What is a part of your assessment for a patient that is presenting for GI disease?
- TPR
- hydration status
- fecal score, rectal, abdominal palpation
- skin/coat exam
- pain score
- attitude and behavior
- CBC/Chem: anemia, hypoalb
- peripheral edema, ascites?
- +/- cobalamin, folate, TLI, PLI, c/fPL, 25-hydroxy vitamin D
- abdominal u/s or xray
- canine chronic enteropathy activity index
What is the management for GI problems caused by dietary indiscretion?
reduce or eliminate exposure
what is the management for bilious vomiting syndrome?
Divide daily meals into 3-4 meals as opposed to 1-2
What are dietary options for managing diarrhea?
- highly digestible diet
- fiber-enhanced diet
- fat-restricted diet
- hydrolyzed or NP diet
- properly formulated homemade diet
why is a highly digestible diet appropriate for acute diarrhea cases?
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
T/F: using metronidazole for acute diarrhea is inappropriate and causes dysbiosis that can be long term
true
T/F: environmental enrichment is considered another component of managing diarrhea
true because stress plays a role in abnormal stool (esp in cats)
what are characteristics of large intestinal diarrhea?
increase urgency
increased frequency
straining
mucus
blood (hematochezia)
what is the treatment for fiber-responsive large bowel diarrhea?
enhance dietary fiber
carbs with b-glycosidic bonds
T/F: crude fiber represents total dietary fiber (TDF)
false – crude fiber underrepresents total dietary fiber (TDF)
What are fiber supplements that can be added to diets for fiber-responsive diarrhea?
- psyllium (metamucil, konsyl, now)
- oligosaccharide prebiotics
- cellulose
canned pumpkin and green beans also options but require larger volumes
what is the treatment for constipation?
- high fiber GI diet, weight loss diet, or psyllium enhanced diet (if fiber-responsive)
- highly digestible core GI diet or wet diet (if non fiber responsive)
- laxatives (insoluble fiber)
- psyllium (soluble fiber)
what are 2 non-fiber responsive chronic enteropathies?
food allergy
protein losing enteropathies
How can you diagnose and treat hypoallergenic responsive diarrhea?
These patients usually are younger, have low canine chronic enteropathy activity indexes, and concurrent dermatologic issues.
treatment is hypoallergenic diet trial + rechallenge
In order to use a novel protein for a hypoallergenic-responsive diet trial, what do you need first?
a thorough diet history
What is the treatment for protein-losing enteropathies that cause diarrhea?
low-fat diet (lymphangiectasia)
low fat hydrolyzed diet (if lymphangiectasia + inflammatory enteropathy)
how can you manage pancreatitis?
- 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
T/F: pancreatitis is typically primary in cats
false – secondary
you must manage the primary disease to control it, therefore a low-fat approach is typically NOT needed.
why is the fat content in canned foods misleading?
they are typically lower in fat than commercial dry foods on an as-fed basis but not on a dry matter or kcal basis.
what is the dietary treatment for EPI?
highly digestible diet (GI diet)
digestible enzymes mixed with the food
feed smaller meals more frequently.
what is involved in the monitoring of GI cases?
- GI improvement is expected within 2 weeks (or at least trending positively), if not consider a different dietary approach, more diagnostics, or medical management
- check for weight gain and normal BCS and MCS
- monitor appetite
- monitor energy, behavior, and QOL
- +/- monitor serum albumin, ascites, serum cobalamin and/or folate
