Nutrition for Hepatic & Derm Conditions

Question 1

When your patient has elevated liver enzymes without an identifiable cause, what can you enhance in their diet?

Answer 1

antioxidants (vitamin E, silymarin, and S-adenosylmethionine/ denamarin)

Question 2

What dietary modification can you do for biliary disease?

Answer 2

limit dietary fat

Question 3

What dietary modification can you do for hepatic encephalopathy?

Answer 3

restrict protein lower than current diet

enhance soluble fiber (to trap nitrogen in the GIT and reduce blood nitrogen)

Question 4

What dietary modification can you do for copper hepatopathy?

Answer 4

restrict copper

enhance zinc (unless on D-penicillamine)

Question 5

What is the difference between food-allergy dermatitis and food intolerance?

Answer 5

Food allergy dermatitis is T-cell mediated (type IV), can be manifested in the skin, GI tract, or both, and typically takes time to develop/manifest

Food intolerance is IgE mediated (type I) and manifests very acutely.

Question 6

What are the most common allergens reported fr food allergy dermatitis?

Answer 6

dogs: beef, dairy, chicken
cats: beef, dairy, fish

Question 7

What is the gold standard diagnostic for food allergy dermatitis?

Answer 7

strict diet trial for 8-12 weeks

novel protein source (requires thorough diet history) or hydrolyzed diet.

should rechallenge to confirm

Question 8

Why are OTC limited ingredient diets not as great as they sound?

Answer 8

they are likely to include protein or DNA from protein sources that are not disclosed in the ingredient list (ex. soy, poultry, beef)

Question 9

Why are serum and salivary allergy tests not the best diagnostic for food allergy dermatitis?

Answer 9

they have a high chance of false positives for food allergens.

the gold standard is diet trial + rechallenge.

Question 10

What are KEY nutrients for healthy skin?

Answer 10

1. protein (deficiency causes poor skin/coat quality, lightening of coat, etc.)
2. polyunsaturated fatty acids (linoleic acid and omega-3s) help with dry/flaky coat and pruiritus
3. trace minerals (zinc, copper)
4. vitamins (pantothenic acid, nicotinamide, choline, inositol, niacin, vitamin A, vitamin D.

Question 11

How can you identify zinc-responsive dermatosis?

Answer 11

look at the nose and foot pads

Question 12

What is copper essential for?

Answer 12

melanin production
keratin production