Nutrition- Final- 1

drraythe's version from 2016-04-29 15:37

Intro powerpoint

Question Answer
If you put a pet on a therapeutic diet, you need to...have them back to reassess!
why might an animal on a poor diet still have decent lab values?because the body is a big reserve that they can pull from-- so you might not see lab abnormalities (like low k+ in a meat free diet) until they run out of reserves (burn up all their lean body mass)
what is the main reason there is a low or no protein diet?usually stones (dec urea/nitrogen= dec medullary gradient= more dilute urine)
what are the 2 main lab abnormalities you see on a low or no protein diet? what U/A abnormalities will you see?LAB: Low Creatinine kinase and BUN (protein has nitrogen and BUN has nitrogen in it, so it's low. And creatinine kinase breaks down creatinine, if there isnt creatinine which comes from muscle, there is no need for that CK). On U/A, you will see lwo SG of urine bc urea-nitrogen is used to make medullary gradient in the kidney-- with low levels there is medullary washout and the concentrating power of the kidney is dec.
nutrient of concern for kidney dz?phosphorus
what is body condition score scoring?Body fat percentage!! so the highest score isnt the fattest animal you have ever seen-- it's just it has at least or more than 40% body fat
what is mm condition scoring about? what should you look for?3 point scoring system used to look for CHANGE in muscle, see if there is wasting.
what is "overcoat" syndrome?patient has more body fat than muscle, masking muscle loss
what are the 3 scores of the mm condition scoring?1. Marked/severe muscle wasting, 2. Moderate muscle wasting 3. Normal muscle mass
where on the body is a good place to check mm condition scoring?he likes to check flat bones-- like scapula, skull mm, the ilium and ischium. find mm over those. great area.
what is an idea BCS score, and how would you describe that?3 (or 5)= Ideal. Ribs – Easily felt with slight fat cover, Tail Base – Smooth contour with slight fat cover, Side View – Abdominal tuck. Overhead view – Well-pronounced waist.
about what % body fat correlates with the BCS 1-5 scores?1: <5%. 2: 6-14%. 3: 15-24. 4: 25-34. 5: 35-45+
the main steps for an assessment and feeding plan?Step 1: Assess the animal. Step 2: Assess the food(s) Step 3: Assess the feeding method. Step 4: Select a food(s) Step 5: Determine a feeding method. Then Monitor patient response and return to step 1.
you should always base your food selection on?KNFs-- key nutritional factors
what should you know about species specific food?CAT FOOD FOR CATS. you might get away feeding a dog cat food, but cats CANNOT eat dog food
how do you know if Nutrients are digestible and bioavailable in the food?passed feeding trial, or youve seen it fed and it works
explain this nutrient graph a bit in terms of therapeutic diets so in diets you bring them to the REDUCED INTAKE part-- dont actually put them into deficiency. So you fiddle up and down this graph to help with organ problems. So an example is a kidney diet is lower in phosphorus- it is reduced intake tho, not deficient
what does it mean if a diet is a Complete and balanced diet? what do you need to be careful about?it means that if you feed to meet the animal's energy requirements the requirements for non-energy nutrients are automatically met. CAUTION: This means if you try to feed less food as a way to make them lose weight, you might not be meeting all their requirements-- this is why special diet food exists.
What is the resting energy requirement?E used by adult at rest in a Thermoneutral environment. This energy requirement Does not support activity, growth, or reproduction
***what is important to know about using their body weight for calculating RER?USE THEIR IDEAL BODY WEIGHT!!! if they are overweight, you need to know their ideal body weight... There is the article he gave us, look at chart and they show how to estimate ideal bwt. Can also try to figure it out with BSC score correlating with what % body fat
(said they would give us equations) what is the main equation for calculating RER?(IDEAL BODY WEIGHT IN KGS x 30) + 70 <--THIS EQUATION ONLY WORKS IF BWT IS 2kg-45kg tho!! (otherwise need to use formulas of either 1000kcal/m^2, OR 70(bwtkg)^0.75 )
what is the Daily energy requirement (DER)?RER plus calories needed for: Temperature regulation, Digestion & elimination of nutrients, Activity, Lifestage (growing? lactating?), Neuter status
how do you calculate their DAILY energy requirement?you take a factor based on that patient (are they neutered? intact? obese prone? is this for weight loss? weight gain?) and multiply it by the RER. (NOTE: remember all these calculations are at IDEAL BODY WEIGHT)
if you arent sure which factor to pick to calculate your DER, you should err on the _________ sideLOWER side-- animals underweight live longer than if they are overweight.
what are some things that make cats more obese-prone?we neuter them and keep them inside. Disrupt normal hormones.
Food Dosage Determination- calculation steps to determine food dose?(1) Estimate RER (ideal body wt. in kg) (2) RER × factor= DER (est.) (3) Select specific food & determine energy density (4) Determine food dose
so you have how many kcals the animal should eat in a day, and you have how many calories are in a unit of dog do you math to how much you should feed?Energy requirement/energy density of food (so example is if they need 369kcal a day, and a cup of food has 350 kcal in it... you 369/350= 1.05cup/day))
tell owners to be careful about measuring cups, because...An 8 ounce measuring cup holds 8 fluid ounces (volume) not 8 ounces of weight

Skipper case- unbalanced diet

Question Answer
So if a dog has chronically been on a Ca++ deficient diet, it can die right before your eyes--- why?PATHOLOGICAL FRACTURES OF THE SPINE-- not cardiac or anything. If they jump off the table their body can just break.
whats a major problem with raw / soujours diets (what are they deficient in)deficient in CALCIUM! If the bones that diet provides are too big, they wont eat them. And soujours too high in P and not enough Ca++...makes it worse.
which will pull Ca++ out of bone- alkelemia or acidemia?Acid pulls Ca++ out of bones (remember putting chicken bones in pop)
why are dogs with osteoporosis painful?its not the osteoporosis- its the microfractures that come with it
What is the endocrine thing going on with a Ca++ deficient diet?2* nutritional hyperparathyroidism. Not enough Ca++ in blood/too much P--> PTH released--> osteoclasts activated--> Ca++ resorbed from bone
If you are going to put an animal on a low or deficient diet for therapy, what is super important to know?YOU NEED TO SEE THEM BACK. These diets are meant for SHORT TERM and if the owner doesn't realize, bad things can happen. THESE ARE NOT BALANCED DIETS.(such as lack of protein for skin allergies)
If you are going to measure creatinine, do you want it fasted or postprandial?SHOULD BE FASTED SAMPLE
where does creatinine come from in the diet?MUSCLE!!!! so protein deficient diets will have low creatinine. (high crt can mean breaking down muscle- however in this case skipper has already used all her lean mass)
If a calcium and protein deficient diet, why is Alkaline phosphatase high?Lack of Calcium is leading to resorption of bone, and this enzyme is IN bone, so it is released and you see elevated levels.
what other thing in the blood might affect Ca++ levels?Albumin- remember there is bound and unbound Ca++. If protein deficient, Ca++ might look higher (in this case hers is still too low tho)
if you are going to feed dogs plants (like green beans) what should you remember about nutrient availability?a lot of fiber, some nutrients in there, but dogs dont have phytase (enzyme) to break it down so although there are nutrients in it, they can't use them
what is it called when older creatures start to lose lean mass- how can you help avoid this?sarcopenia- (sarcolemma in mm) only way to maintain is resistive exercise and adequate protein intake
how much protein in the diet before it just starts getting wasted? what is the process by which it is wasted?if above 18% on a DM basis, you start to see inc nitrogen loss in the urine because the body can't use all the amino acids-- and if you have kidney problems, they might be overwhelmed by all that urea (so bloodwork for old pets!)
*What are mineral levels like in geriatric diets? why?older-->loss of organ function. Organs get rid of most need to have LOW MINERAL DIETS
*what is geriatric diet like for... minerals? Fat? Protein? Fiber? Calories?LOW in minerals (organs cant handle it anymore), low in fat (in case obese), can be high or low in protein (just not excessive which would burden the kidneys), low calories (dont want to be obese), fiber is high
if an animal needs calcium-- how do you give it?depends on how they lost it-- if acutely lost (like eclampsia) give IV. if chronically lost (like dietary deficiency), give ORAL. DONT have to start low- body will absorb it up right away
Ca++ is ___ DMB according to AAFCO. (dont think he would ask this, but..)0.6-2.5%
what happens if you give too much Ca?Ca and P interact-- forms mineral complexes and they just poop it out So above 1.8%....start seeing complexing with other minerasl. Esp in cats.
If only it was as easy as giving Ca++....what other two things do you need to consider and balance?P and Vitamin D!! You need the vitamin D to absorb the Ca. HOWEVER BE CAREFUL, too much vitamin D can be toxic, including at human doses (causes hypercalcemia- BVs and kidneys will calcify). Also dogs can't make active vitamin D from the sun. so vit D is like 50 IU per kg of food for maintenance.
what drugs can lower Ca levels in the blood?Steroids!! makes them pee it out
"hypoallergenic" food doesn't exist, but what does is..novel protein, hydrolyzed protein
If you need to transition animals from one food to another, what is a good way to do that (in terms of form of food)start with close to what theyre familiar with- if on a homemade diet, try to move to wet food first
what kinda diets might you wanna start a deficient diet dog on?puppy or growth usually
If you need lots of minerals in your diet, which brand might not be the best choice?hills doesnt believe in excess minerals
you can't feed a dog too fast if it has been starving, or else you will be dealing with....refeeding syndrome (inc food-- insulin spikes- drives K into cell with it-- hypokalemia). Skipper was eating though, but vili might still be a bit blunted.
why not feed a starving dog free choice?on top of the risk of refeeding syndrome, you also have this problem: The vili blunt w/in a week or two, and the stomach shrinks up and motility dec. in small intestine, loss of villi and loss of mucosal surface area. Most microbes in large intestine. but dec motility--> the bact move up. and the pancreas exocrine portion atrophies. no motility, lack of digestive food is digested or absorbed. and lots of microbes. so nutrients fermented. so LOTS of diarrhea. and then acidosis and they will die. and severely hypoproteinemic which is an acid base balancer, so acidemia even worse
What about in the case of skipper-- skipper has been eating, so can you feed her free choice? starvation mode, body wants to store fat. But we want her to gain lean mass. So need to transition. we have to transition dog into new food. so need to correct old diet. add vitamin mineral suppliment and about 4 more tums. biggest factors at this point--than start moving more protein into it. if you change a ton right away you can see vomiting and diarrhea. slowly reintroduce new nutrients. 7-10days to reintroduce it. Also start with small, frequent meals
what is the big problem with chicken and rice meals?dogs don't want to go back to normal food again!! he would prefer commercial highly digestible low residue diet like ID or something
if the dog is super osteoporotic, how long will it take bones to get back to normal, and what should the owner do in the meantime?cage rest bc concerned about fractures. don't have them out unless have to pee. takes about 6 weeks for bones to get calcium back into them and good callus formation for previously existing fractures. Fractures are #1 risk so #1 part of diet you need to worry about is calcium!!!