Small animal clinical nutrition - the convalescent patient Flashcards
BASIC PRINCIPLES OF CLINICAL NUTRITION (4)
Feed animal with this food only.
Follow the recommended quantity and the number of meals, prescribed by
your vet.
Clean drinking water must always be available.
Every therapeutic food has an initial length of feeding period, even if the food is likely to be prescribed for life (reevaluation after a set amount of time).
HOW THERAPEUTIC FOODS WORK
2 Main goals:
To reduce the levels of nutrients which cause and / or extend the disease.
To increase or add nutrients to support and restore the sick organ or organ system.
NB! It takes time for the food to take effect (couple days - couple months).
The first therapeutic diet is considered to
be
the one, Dr. Mark Morris developed
for Buddy, who was the guide dog for WWI blind veteran Morris Frank.
Buddy had a renal insufficiency and dr. Morris prescribed him special food with high quality ingredients and reduced Na levels, which he himself with his wife made in their own kitchen.
This is the „grandfather“ of hill’s k/d diet.
How to help owners understand special dietary requirements? (4)
Don’t use overly complicated language when instructing on feeding.
All instruction should be given in written form as well.
Use booklets, leaflets or pamphlets provided by some veterinary diet companies.
Be specific about quantities; educate the owner to measure (or weigh) rations.
If the daily quantities have to be divided, give clear instructions that this is the case.
WHY IS IT IMPORTANT TO OBSERVE ASSIGNED DIET, FOOD QUANTITIES AND FEEDING ARRANGEMENTS (3)
In some cases, even a piece of the „wrong food/feed“ can ruin the entire treatment plan (i.e. elimination diets).
For weight reduction, very precise
measurement of consumed food/calories is required.
In case of diabetes, precise meals at precise times are the main key to successful insulin treatment.
NB Give food time to start „working“
etc.
HOW TO PROPERLY CHANGE FROM
ONE DIET TO ANOTHER? (4)
The transition from one diet to another has to be done gradually, by mixing new food with the old one, gradually increasing the quantity of new one and decreasing the old one.
It gives the animal and its GI tract time to get used to the new texture, smell, taste , etc.
Transition period 5-7-10 days (gut renewing/healing time).
Except acute digestive problems, when sometimes more rapid transition is
indicated (and safe).
NB! Be careful with fasting. For certain diseases some period of time is required for the food to begin working.
Transition period for switching to new food.
Transition period 5-7-10 days (gut renewing/healing time).
Except acute digestive problems, when sometimes more rapid transition is
indicated (and safe).
HOW TO ENCOURAGE SICK PET TO EAT? (5)
As a rule, canned food is considered to be more tasty.
Heat canned food on water bath, grill, pan or in microwave (beware „hot spots“).
Add some lukewarm water to dry food, mix properly and allow to soften in time (dogs).
Feed from hand.
Mix some of pet’s favorite food or treats with diet (only in beginning and if this
is not contraindicated!).
HOW TO MAKE DOGS AND CATS TO INCREASE WATER INTAKE? (6)
Ensure, that the drinking water for pets is always fresh.
Water to every room.
Flavored water?
Prefer cans to dry food.
Different bowls in different places and levels.
Cat fountain or faucet constantly opened slightly.
CLINICAL NUTRITION DURING RECOVERY PERIOD (4)
To achieve maximum benefit, the emergency patient must be fed in the earliest stage of recovery as possible (to avoid hypermetabolism and auto cannibalism).
Food has to be very tasty and with high energy density. If the gut works, use it!
Food has to support the immune system – arginine, zinc, omega-3 fa, selenium, various vitamins (in abundance).
Ensure, that the nature and physical properties of food allow it to be used with a variety of feeding methods (voluntary eating, feeding by a syringe or through a tube.
THE CONSEQUENCES OF INSUFFICIENT
ENERGY CONSUMPTION (7)
- Immune suppression
- Organ dysfunction
- Wound healing ↓
- ↓ metabolism of drugs
- Muscle loss and weakness
- Cases of acquired infections↑
- ↑ Cases of death
Most important nutrient.
water!
ENERGY CONTENT OF NUTRIENTS, rule of thumb. (3)
Proteins 3,5 kcal/g
Carbohydrates 3,5 kcal/g
Fats 8,5 kcal/g
Minimum KCAL program for patients in the stationary ward. Dogs and cats.
DOG: RER = 70 (BWkg)^0,75
CAT: RER = 70 (BWkg)^0,67
For animals in energy deficit, avoid the use of what as your energy source?
Avoid protein in these cases.
Ideally provide all needed calorie
requirements from fats and carbohydrates, and then, provide the requirements for protein maintenance with the help of amino acids. The last resort should be an organism needing to use protein for energy rather than anabolism.
