Specific diseases Flashcards
What are the considerations for feeding for CKD
Poor appetite
Poor BCS
Lyte and acid base derangements
Polyuria can lead to loss of water soluble nutrients
What is the evidence for renal diets?
Dogs - improved survival and reduced uraemic crises stages 3-4
Cats - improved survival stages 2-4
What are the properties of renal diets?
Energy dense to balance reduced intake Phos restricted to prevent renal secondary hyperparathyroidism Protein restricted to minimise uraemia Low Na to counteract hypertension K+ and vitamin supplementation Alkalinising
What are the features needed of a diet for a PLN?
Moderate protein restriction
Low Na to minimise hypertension
Omega 3 FAs - decrease the degree of proteinuria
What are the benefits of omega 3 FAs
must be fish oil to supply EPA and DHA
Lead to a decrease in the production of inflammatory mediators
Used in cardiac disease -reduce arrythmias in cardiac disease
Good in PLN
also used for neoplasia and OA
reduces inflammation, lowers systemic arterial pressure, alters plasma lipid concentrations, and preserves renal function
What are the main components of a urolith diet?
Increase water consumption either by increasing moisture or adding Na to increase thirst
Decrease in the dietary precursors to the stone (e.g. Mg and phos in struvite)
alter the pH
What are the types of diet trial?
Novel protein (Hx essential, may need to do home cooked) Hydrolysed (minimises immunogenicity, can still get reactions)
Outline soluble fibre
Mostly from fruit Increases bacteral fermentations Adds moisture - get decrease faecal bulk Decreases small intestinal transit time Adds water, moistens the f+
Outline insoluble fibre
e.g brans, woody things Adds bulk Increases SI transit time Normalises LI transit time Decreases f+ water content
What are the dietary risk factors of pancreatitis?
Ingestion of unusual food items
Table scraps
Eating from a bit
Obesity/ neutered
When is a low fat diet helpful in pancreatitis?
In chronic pancreatitis
When the patient is obese
When there is hypertryglyceridaemia
how much should you feed in critical illness?
RER only - and gradually introduce this Complications with feeding more: High BG, azotaemia, hypertryglyceridaemia, lyte disturbances V+ or regurge or tube feeds Re-feeding syndrome
What sort of diet should be given in critical illness?
Balanced
high quality, quantity and digestibility of protein - want to minimise negative nitrogen balance, need to ensure all the conditionally essential amino acids ae available
Moderate fat content to increase energy density
Supply with necessary micronutrients and antioxidants
Why is important to limit hypertension in renal disease?
BPs over 180 shown to increase the likelihood of uraemic crisis and death in dogs
No real evidence for reducing sodium for now as evidence is mixed on the benefits and cons of restricting sodium
Why avoid metabolic acidosis in renal disease?
Increases renal ammoniagenesis which contributes to renal failure
Increases catabolism and degradation of skeletal muscle protein
disrupts intracellular metabolism, and promotes dissolution of bone mineral, exacerbating azotemia, loss of lean body mass, and renal osteodystrophy
What alkanising agents can be used for reduced renal metabolic acidosis?
sodium bicarbonate, calcium carbonate, or potassium citrate
Why are omega 6 FAs avoided in renal disease?
Cause an acute increase in GFR
What nutrients are antioxidants that trap free radicals?
vitamin E, vitamin C, taurine, carotenoids, and flavonols
What are the main recommendations for feeding hyperthyroid cats?
large amount of dietary protein
a small amount of carbohydrate
and a moderate amount of phosphate
How should diabetic cats be fed?
Because cats are obligate carnivores, diabetic cats are carbohydrate intolerant and respond best to a low-carbohydrate diet
Because diabetes is a catabolic state, weight loss, muscle wasting, and poor muscle condition scores are common in diabetic cats; therefore, feeding high-protein diet helps maintain muscle mass
How does hyperthyroidism affect insulin
moderate to severe endogenous insulin resistance,
This insulin resistance is associated with a decreased glucose clearance (impaired glucose tolerance), which indicates a prediabetic state
Some cats may become overt diabetics - this may not resolve, and may get worse, with hyperthyroid treatment
How does hyperthyroidism affect the kidney
increases GFR which can lead to damage
Lots develop hyperphosphataemia and high PTH which can lead to renal secondary hyperparathyroidism
How do maintenance energy levels change with age in cats?
3% per year until the age of 11 years, and then start to increase again
What are the key goals in a hyperthyroid diet?
allows weight gain (back to optimal body weight) and helps restore loss of muscle mass;
lessens postprandial hyperglycemia, improves insulin sensitivity, and helps stabilize glucose metabolism;
helps control hyperphosphatemia and secondary hyperparathyroidism and slows the progression of any underlying kidney disease.
