Small animal clinical nutrition - cardiac & liver diseases Flashcards
Describe nutritional management of cardiac diseases. (4)
Restricted sodium levels to reduce swellings and workload of heart. With the new ACE inhibitors, this does not require such aggressive restriction.
Very palatable and high in energy as patients are anorexic and need more energy.
Increased levels of magnesium, potassium and B - group vitamins to cover the
deficiencies due to diuretic action.
Cardiomyopathy in cats does not require protein restriction, but needs enough B-vitamins and taurine.
Animal with liver diseases are often catabolic and therefore need
more energy.
Must provide sufficient quantities of high quality proteins and calories, to ensure positive protein balance and hepatic recovery.
Acute liver conditions are most commonly caused by
poisonings. Are rarely due to infections, trauma, heat stroke or vascular diseases.
Acute liver condition animals are often fed by
feeding tube for 24-72h, after this gradually switching to per os.
Most common symptoms of acute liver condition are (4)
vomiting and diarrhea; but also HE (hepatic encephalopathy), DIC (disseminated intravascular coagulation)
Feed acute liver patients how much protein?
Normal protein content (ca. 20%),
except in cases of HE (hepatic encephalopathy).
Ammonia is a byproduct of protein metabolism, and the liver usually detoxifies it by converting it to urea, which is then excreted by the kidneys.
A high-protein diet results in more ammonia being produced, which the damaged liver cannot adequately process.
But note: Its important, that proteins are not extremely restricted, because they are needed for liver restoration,
What is s-adenosyl methionine?
How does it relate to animals with hepatic encephalopathy?
S-Adenosyl methionine is a naturally occurring compound, found in the body, that is essential for various biochemical reactions in the liver, including methylation and detoxification processes.
In animals with liver disease, SAMe levels are often decreased, impairing the liver’s ability to function properly.
+SAMe is a precursor to glutathione, one of the most important antioxidants in the body, particularly in the liver so its Especially needed in the event of acute liver damage to support liver cells in glutathione production.
Cause of chronic hepatic insufficiency
The cause is not normally clear.
Abnormal accumulation of copper or damage caused by medicines/
poisons.
Nutritional management in cases of chronic hepatic insufficiency.
Diet has to be extremely palatable and with high energy density.
Should have a normal fat content (energy and taste).
Should contain sufficient high quality proteins (15-20%)
Should have restricted copper and sodium levels.
Should have added zinc, B-vitamins and antioxidants as well as added glutathione.
What is glutathione and why is it important in liver disease?
Glutathione is a powerful antioxidant that plays a crucial role in maintaining cellular health and detoxifying harmful substances in the body, particularly in the liver. It is a tripeptide made up of three amino acids: glutamine, cysteine, and glycine.
Glutathione is crucial for detoxification in the liver. It binds to harmful substances, such as drugs, chemicals, and metabolic waste products, and transforms them into less toxic forms that can be safely excreted from the body through urine or bile.
This process is called glutathione conjugation, and it’s a key step in the liver’s phase II detoxification pathway.
+Glutathione neutralizes free radicals by donating electrons, preventing them from damaging liver cells.
Name 3 important substances to supplement in case of liver disease.
S-Adenosyl methionine
N-Acetylcysteine
Direct glutathione
S-Adenosyl methionine (SAMe): As mentioned earlier, SAMe is a precursor to glutathione and can help boost glutathione levels in the liver.
N-Acetylcysteine (NAC): NAC is a widely used supplement that serves as a precursor to glutathione by providing cysteine, the rate-limiting amino acid in glutathione synthesis.
Direct glutathione supplements: Although oral glutathione is available, its absorption is limited.
Name to causes of hepatic encephalopathy.
e.g. portosystemic shunt or serious liver disease
Hepatic lipidosis in cats is typical to what type of patient? (signalment)
Idiopathic hepatic lipidosis in cats is most common in middle age obese cats.
It is most commonly appears after a period of partial or complete anorexia, which is normally caused by stress.
Clinical signs of hepatic lipidosis in cats.
Partial or total anorexia for 7 or more days
Depression
* Jaundice
* Weight loss
* Loss of muscle mass
* Occasional vomiting/diarrhea
Describe treatment of hepatic lipidosis in cats.
Early diagnosis is necessary for successful treatment.
The primary treatment is tube feeding. The Food must be high in energy and protein.
Most cats need 3 to 6 weeks of intensive treatment before the appetite recovers and the condition passes.
Home feeding options include:
* Blending high protein content cat foods
* Digestive products for human consumption
* Gastrointestinal foods for cats
