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Small Animal Nutrition > vomiting, diarrhea, pancreatitis > Flashcards

vomiting, diarrhea, pancreatitis Flashcards

1
Q

Describe dietary lipid absorption for LCFA

A

a. Hydrolyzed to monoglycerides (MG) and free FA (FFA) via lipase (of pancreas)
b. Packaged into micelles or lipid droplets (MG + FFA + bile salts)
c. Micelles diffuse across SI into enterocyte
d. Reformed triglycerides in chylomicrons
e. Chylomicrons transported via lymphatics (so lymph system must be working for lipid metabolism to occur), go form lymphatics into blood

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2
Q

Describe dietary lipid absorption for MCFA

A

a. More water soluble
b. High percentage of dietary MCT absorbed directly into portal bloodstream.
i. Useful source of energy if fat absorption is impaired
c. Prepared by hydrolysis and fractionation of coconut oil
d. One tablespoon (15 ml) = 115 kcal
e. Dose: maximum of 25-30% of calories

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3
Q

Define malassimilation

A

Failure of nutrients to pass across the intestinal wall in quantities sufficient to maintain
body weight and condition
- includes malabsorption and maldigestion

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4
Q

Malabsorption

A

diseases that alter structure/function of mucosa plus lymphatics

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5
Q

Maldigestion

A

Defects in intraluminal digestion as a result of gastric (enzyme), pancreatic (enzymes), or biliary dysfunction

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6
Q

Impaired colonic water/electrolyte absorption, accelerated colonic transport, and loss of bile salts lead to….

A

diarrhea, specifically steatorrhea (can see greasy, lipid droplets on/in feces

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7
Q

Gut peptide release inhibition of gastric emptying/small bowel transit leads to…

A

vomiting

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8
Q

Loss of food energy leads to…

A

weight loss

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9
Q

Loss of EFA (essential fatty acids) leads to…

A

EFA deficiency; can see dull hair coat

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10
Q

Loss of fat soluble vitamins leads to…

A

vitamin deficiency; if it is vitamin D will see bone loss

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11
Q

Loss of minerals Ca and Mg leads to…

A

bone loss

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12
Q

Dietary management of steatorrhea

A

treat underlying malassimilation (PEI, inflammatory intestinal disorders, motility disorders, short bowel disease)

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13
Q

Dietary management of fat soluble vitamin/EFA deficiencies

A
  • treat underlying malassimilation
  • correct dietary levels
  • parenteral administration of vitamins
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14
Q

Dietary management of weight loss

A

ensure adequate kcal intake

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15
Q

Dietary management of bone loss

A

treat underlying malassimilation

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16
Q

Dietary management of vomiting < 3 days duration

A
  • NPO for 12-24 hrs then small quantities of water every 2-3 hrs (ice cubes)
  • food re-introduction: feed small frequent meals (4-6X/day), HIGHLY DIGESTIBLE DIET, MODERATE TO LOW IN FAT (relative to current diet), gradually increase food amount over 3 days, transition to regular diet after 5-7 days
17
Q

Dietary management of vomiting > 3 days duration

A
  • correct fluid, electrolyte, acid-base imbalances
  • provide adequate nutritional support if hasn’t been eating normally for 3+ days
  • treat with antiemetics (can improve ability to use enteral feeding)
  • re-introduce water, then food when vomiting is controlled/resolved
18
Q

Osmotic diarrhea

A
  • common cause in dogs and cats
  • unabsorbed nutrients (solutes) in bowel -> passive diffusion of water into gut lumen -> passage of large volume of fluid or liquid stool (+/- steatorrhea)
  • resolution after 24-36 hr fast (may be responsive to diet change/alteration or fasting)
19
Q

Exudative diarrhea

A
  • caused by altered mucosal permeability of large or small bowel
  • GI erosions, ulcerations, mucosal inflammation/infiltration-> alter gut permeability barrier -> diarrhea
  • fresh and/or melenic blood in the stool, inflammatory cells in stool
  • may present as protein losing enteropathy (PLE)
  • NOT completely resolved with fasting
20
Q

Abnormal GI motility diarrhea

A
  • uncommon in dogs and cats
  • ‘Ileus’ -> rapid intestinal transit -> ‘pipe’ effect (things just move on through); may be in conjunction with dz, pain, post-sx, or drugs
  • small intestinal bacterial overgrowth (SIBO); sequela to altered peristalsis
  • response to dietary manipulation is variable
21
Q

Secretory diarrhea

A
  • uncommon in companion animals
  • secretagogues stimulate this type of diarrhea; GI hormones, bacterial endotoxins, drugs, hydroxylated fatty acids (undigested fat that bacteria act on), and unconjugated bile acids
  • fluid production by crypt epithelial cells
  • large volumes fluid diarrhea resulting in rapid dehydration
  • fasting NOT successful in alleviating clinical signs
22
Q

Dietary management of diarrhea (general)

A
  • intestinal rest for 24-48 hrs and maintain hydration status; IV, SQ fluids
  • offer small amount of water, ice cubes, or oral rehydration solns (rebound, pedialyte)
  • small amounts of food 4-6X/day
23
Q

Dietary management of diarrhea (diet)

A
  • restricted fat (dogs 8-15% DMB, cats 15-25% DMB)
  • increased electrolyte content (Na, Cl,K)
  • crude fiber (low to increased depending on clinical picture)
  • highly digestible CHO (rice, corn)
  • protein (feed level suitable for life stage)
24
Q

Highly digestible diet (low in fiber) for diarrhea management

A
  • good for small bowel diarrhea
  • decreased residue in the intestine
  • decreased intestinal work
  • decreased undigested or unabsorbed ingesta passing to colon
25
Q

Hypoallergenic (novel/hydrolyzed) diet for diarrhea management

A
  • minimizes hypersensitivity
  • resolve diarrhea induced by ‘food hypersensitivity’
  • when hydrolyzed protein don’t need as much work by gut to digest, need less enzymes
26
Q

Fiber enhanced diet for diarrhea management

A
  • binds excess water, SCFA production, normalizes motility and GI microflora
  • beneficial for large bowel diarrhea (also good for stress colitis)
  • diet options: diets for management of diabetes mellitus, constipation, obesity
  • fiber suppliments (ie psyllium, cereals high in fiber)
  • move electrolytes back into colon, fermentability varies
27
Q

Is there a diet for diarrhea management that includes high digestibility, novel/hydrolyzed protein, fiber enhanced?

A

Yes, royal canin fibre

28
Q

Pancreatitis clinical assesment

A
  • acute vomiting (mild-severe): dehydration, depression, fever
  • abdominal pain, anorexia, diarrhea
  • cats are special: tends to be chronic in nature, pu/pd, weight loss
  • dietary indiscretion at least 24 hrs prior to episode, intake of high fat table food (dogs), high-fat/ low-protein diet (avoid these foods in animals with history of pancreatitis)
29
Q

Cause of pacreatitis

A

unknown/idiopathic

30
Q

Risk factors of pancreatitis

A
  • hyperlipidemia (obesity, idiopathic hyperlipidemia in mini schnauzers)
  • high-fat/ low-protein diet (dogs- ex. hill’s s/d)
  • hypercalcemia
  • drugs (ex. phenobarb)
  • ischemia (reperfusion of the pancreas)
  • manipulation or trauma
31
Q

Etiopathogenesis of pancreatitis

A
  • autodigestion of the pancreas by the enzymes it secretes (abnormal vacuoles are formed and become activated in the pancreatic tissue rather than GI lumen, result is inflammation in the pancreas)
  • dietary fat + protein -> CCK (small intestine) -> enzyme secretion (activated in lumen of GI)
32
Q

Consequences of pancreatitis

A
  • none after recovery
  • affected endocrine pancreas function: diabetes mellitus (likely to have pancreatitis again)
  • affected exocrine function: decreased digestive enzyme production (EPI or PEI)
33
Q

Key nutritional factors for pancreatitis

A
  • highly digestible diet- low in fiber
  • water (perenteral or enteral depending on clinical picture)
  • protein (amino acids stimulate pancreatic secretion, avoid excess but need adequate amt for tissue repai; cats need more % DMB)
  • fat: stimulates pancreatic secretion, low fat (<25% DMB is recommended)

Small Animal Nutrition (10 decks)

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