NUTRITION - Nutritional Support Flashcards
Describe the physiological consequences of inadequate nutrition
When the blood glucose levels are low, glucagon is secreted which triggers hepatic glycogenolysis which breaks down glycogen into glucose. If anorexia continues, increased glucagon and glucocorticoid levels and decreased insulin levels trigger gluconeogenesis which mobilises protein and lipid stores. Prolonged fasting will result in ketosis due to triglycerides being oxidised in the liver to form ketone bodies, a process triggered by increased hormone sensitive lipase
How can acute illness amplify the consequences of inadequate nutrition?
Acute illness results in the increased release of glucagon, glucocorticoids and catecholamines, as well as contributes to insulin resistance which further triggers gluconeogenesis and mobilisation of protein and fat stores
Why does inadequate nutrition increase the risk of hepatic lipidosis in cats?
Inadeqate nutrition results in the mobilisation of fat stores which can increase the risk of hepatic lipidosis
Which liver marker can be indicative of hepatic lipidosis in cats?
An increased in alkaline phosphatase (ALP) on bichemistry can indicate hepatic lipidosis in cats
What are the three main consequences of inadequate nutrition?
Poor tissue repair
Immune dysfunction
Altered drug metabolism
How does malnutrition impact septic patients?
Patients with malnutrition will have poor tissue repair and immune dysfunction, which will increase their risk of sepsis. Sepsis will result in decreased food intake as the patient will be feeling unwell, which will worsen the malnutrition and thus worsen the sepsis
What are four key signs of a poor nutritional status that you should look out for when carrying out your nutritional assessment?
Body condition score of less than 3/9
Recent weight loss of over 10% body weight
Generalised muscle wastage
Hypoalbuminaemia
What risk should you be aware of in obese cats that suddenly lose lots of weight?
Obese cats that rapidly lose lots of weight are at an increased risk of hepatic lipidosis
What are five possible causes of anorexia?
Physical inability to eat
Underlying disease process
Nausea
Pain
Impaired olfaction/taste
Why is it so important to identify the underlying cause of anorexia?
Identifying the underlying cause allows for the most effective management i.e if the underlying cause is pain, begin analgesia, or if the underlying cause is nausea, begin anti-emetic therapy
Give an example of an appetite stimulant commonly used in the UK
Mitazepine
When should you begin nutritional support in a patient?
If the patient has been anorexic for over five days or if you anticipate the patient will have ongoing inadequate food intake, especially in patients undergoing surgery who may develop anorexia post-operatively
What are the two classifications of nutritional support?
Enteral nutritional support
Parenteral nutritional support
When is enteral nutrition the preferred method of nutritional support?
Enteral nutrition is the preferred method of nutritional support when the gastrointestinal system is still functioning normally and can absorb nutrients
What are the four methods that can be used to provide enteral nutritional support?
Naso-oesophageal/naso-gastric tube
Oesophagostomy tube
Gastrostomy tube
Jejunostomy tube
What is parenteral nutrition?
Parenteral nutrition is intravenous nutritional support
