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Anesthesia 2 > Nutritional therapies > Flashcards

Nutritional therapies Flashcards

1
Q

chronic pain impact

A

-QOL
-Owner animal bond
-can be subtle and slow progression
-behaviour changes
-may not appear as expected or might only be visible at home

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2
Q

Nutritions impact on chronic pain

A
  1. Diet can be inflammatory
  2. Nutritional deficiencies- may decrease drug efficacy and impair function
  3. Nutritional management can benefit certain diseases (osteoarthritis, GI diseases, pancreatitis)
  4. Body and muscle conditions- frailty, and pain infects food intake . Excess fat= inflammation
  5. Influence on development (bones/joints/health)
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3
Q

Nutritional Assessments

A
  1. Diet history (food and supplements)
  2. Individual nutritional factors (species, life stage, activity, health status)
  3. Appetite and food intake (food preference, intake)
  4. BCS- method to estimate body fat %
  5. Muscle condition (Assess localized and generalized muscle conditions)
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4
Q

Developmental orthopedic disease (DOD)

A

-Large/giant breed puppies
-increased hip/elbow dysplasia, OCD, HOD

**nutritional management plays a major role

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5
Q

Osteoarthritis

A

-nutritional deficiencies in people contribute (antioxidants, B-vitamins, minerals)
*be aware of overdoing minerals

-nutraceuticals may modulate presentation and progression

-body composition (excess fat= pro inflammatory= increased physical stress; poor fat/muscle=frail=weakness/instability and poor immune function)

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6
Q

3 Key factors of Developmental Orthopedic Diseases

A
  1. excessive calories= growth is too rapid; excess stress on developing joints
  2. Calcium intake
    -deficient or excess
    -puppies cannot regulate intestinal Ca uptake
  3. unbalanced diets negatively affect growth
    -nutrient deficiencies, excesses, inappropriate ratios
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7
Q

Recommendations to minimize developmental orthopedic diseases

A
  1. Maintain lean BCS (4/9) and follow normal growth curve
  2. Diet for Large breed puppies. No vits/mineral supplements because unbalance
    -upper limit of allowed Ca is lower in growth diets
  3. Feed large breed growth diet until skeletal maturity complete
    -at least 18-24mths
    -adult size reached before skeletal maturity
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8
Q

Excess body fat

A

-50% of dogs and cats overweight
-increasees biomechanical stress
-increases systemic inflammation (because adipose tissue released adipocytokines)

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9
Q

What does excess body fat lead to?

A
  1. developemental orthopedic diseases during growth

2.development or exacerbation of joint injuries and osteoarthritis

  1. Increased incidence or severity of multiple other diseases
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10
Q

Prevention and treatment of excess body fat

A

-calorie intake
-nutritional adequacy
-activity and environment

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11
Q

Lean group facts from diet restriction study

A

WILL BE ON EXAM
- only 50% developed osteoarthritis
-clinical signs delayed by up to 2 yrs
-avg life span increased by 1.8yrs

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12
Q

Puppy calcium limits

A

3.0-4.5 grams/1000kg

Ratio of Ca:P 1:1-2:1

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13
Q

Multimodal approach of osteoarthritis

A
  1. owner education and counselling
    2.nutrition
  2. modification of home environment and activities
  3. pharmaceuticals (NSAIDs, NGF-Abs- Librela and Solensa, address wind up pain, doses)
  4. Rehab and exercise plans
  5. Platelet rich plasma, stem cell therapy
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14
Q

Treatment for OA

A
  1. Client education=monitor signs
  2. Nutritional plans
  3. Regular controlled exercise
    -low impact
    -maintain muscle strength
    -modify for stage of disease
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15
Q

Nutritional counseling and plan for OA

A

-weight optimization

-adequate EPA +DHA (omega-3s)
*joint diets or marine oils

-secondary: other nutraceuticals

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16
Q

Decision Tree pain management

A

1st tier: weight optimization and omega 3s

17
Q

Most effective therapy to improve mobility

A

Improve body composition/ lose body fat
-benefits with as little as 6.1% weight loss
-cannot just say feed less!

18
Q

Reasons for muscle loss

A

-age related
-disuse atrophy
-dietary issues- inadequate calories, protein or nutrients; rapid weight loss (loss of fat and muscle)

19
Q

Prevention of muscle loss

A

-exercise
-diet (protein quality, total digestibility of diet, adequate total nutrient intake)
-nutraceuticals (EPA +DHA, myostatin antagonists)

20
Q

Nutraceuticals

A

-products made from food substances but in forms usually not associated with food (eg. tablets, capsules, powder, liquid drops, treats) which have shown possible beneficial effects

*therapeutic and omega 3 supplements have some proven success!
*collagen less studied
*chondroitin lack efficacy

21
Q

Vet therapeutic diets

A

Joint support diets- EPA +DHA from marine facts. Sometimes have glucosamine, hydrolized collagen

Weight loss diets
-most effective/safe joint diets to support weight loss
-dont all contains EPA+DHA so may need to add fish oil supplement

Multi function joint and weight loss
-effective and safe for weight loss
-have EPA and DHA

22
Q

Advantages to Vet diets

A

-increased ease of client compliance
-high quality control compared to supplements
-more cost effective than adding supplements
-clinical trials support benefits

23
Q

Disadvantages to vet diets

A

-higher cost compared to avg maintenance diet
-may still need to add supplementation to provide desired total daily dose or other nutraceuticals
-daily dose based on body wgt/size
-dose from diet depends on individual calorie intake

24
Q

EPA +DHA

A

-BEST EVIDENCE OVERALL
-double blinded, controlled clinical trials

25
Q

EPA and DHA in dogs

A

-reduces signs and progression of OA
-improved lameness and weight bearing within 2 mths of use

26
Q

EPA and DHA use in cats

A

-only 1 study: fish oil, green lipped mussel extract, glucosamine and chondroitin

-increased activity compared to controls but placebo effect not controlled

27
Q

Safe upper limit of EPA and DHA

A

Dogs: <370 mg x BW (kg)^0.75

Cats: not enough evidence

28
Q

How do DHA and EPA reduce inflammation?

A
  1. Reduce the degraddation of Arachidonic acid
    *AA results in production of pro inflammatory prostaglandins, thromboxanes, leukotrienes
  2. Increases resolvins and protectins- which decrease inflammatory mediators (PGE2, synovial MMPs (proteases, IL-1, IL-2, TNF-alpha in cartilage/joints)
29
Q

Spoilage of omega 3s

A

-discard by expiry
-keep sealed and in fridge
-test products for contamination of mercury, dioxins, PCBs
-oxidized fish or oil is less effective and less safe

30
Q

Omega 3s- why marine?

A

-terrestrial sources are not a substitute. Can contain omega 3 alpha-linolenic acid (ALA) and conversion of ALA to EPA is poor in cats and dogs

-caution with vit D, Vit A in fish oil
*its high in cod liver oil or salmon oil if not specifically removed
-ensure product is molecularly distilled to remove vit A/D and other impurities

Anesthesia 2 (17 decks)

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