Therapeutic Nutrition II

Adverse Reactions to FoodAcute Care/RecoveryCanine Osteoarthritis

Image Source: www.vet.ed.ac.uk/vclins/research/images/dog.jpg

Adverse Reactions to Food

Adverse Reactions to FoodHow adverse reactions to food manifest:

A. Dermatitis Pyoderma Otitis Dermatitis

B. Gastroenteritis1. Vomiting2. Diarrhea

FOODALLERGY

FOODINTOLERANCE

What are the Culprits?

Chicken, Chicken eggSoy, Lamb

25%

Other7%

Beef, Dairy,Wheat68%

Beef, Dairy,Fish 89%

Other11%

DOGS

CATS

What are the Culprits?

Glycoproteins withMolecular weight of

10,000 – 60,000 Daltons

Source: Hill’s Pet Nutrition, Inc.

Protein Size Matters

Intact Protein

Denatured Protein

Hydrolyzed Protein

Protein Size MattersIntact Proteins 10,000 – 60,000 can cause

release of histamine

Protein Size MattersHistamine release causes allergic symptoms

ALLERGYSIGNS!

Protein Size MattersHydrolyzed protein molecules are too small to

trigger a reaction

Adverse Reaction Goals1. Identify the allergen2. Avoid the allergen

FOOD ELIMINATIONTEST IS MOST

ACCURATE FOR FOOD ALLERGY TESTING

Adverse Reaction KNFsProvide a:

Novel protein source orHydrolyzed protein source

Highly digestible proteinLimited number of protein sources

What Novel Proteins Are Available?Protein Source Available?

Lamb

Kangaroo

Chicken

Alligator

Duck

Whitefish

Opossum

Venison

Rabbit

What Novel Proteins Are Available?Protein Source Available?

Lamb Kangaroo Chicken Alligator X

Duck Whitefish Opossum Aussie dog food

Venison Rabbit

Adverse Reaction ProductsLA Limited Antigen®

HA Hypoallergenic® Gentle Snackers®

Skin and Coat Response FP Skin and Coat Response Response LB

Skin and Coat Response Response KO

Prescription Diet® d/d

Prescription Diet® z/d Low Allergen

Prescription Diet® z/d ULTRA

Hypoallergenic HP 19Novel sources: potato, rabbit, venison, whitefish, vegetarian

Recovery Care

Acute CareIntermediate Care

Critical Care

Source: Hill’s Pet Nutrition, Inc.

Recovery Care

“They’ll eat when they feel better.”

Or

“They’ll feel better when they eat.”

NONO

YESYES

Recovery CareAnorexia – lack or loss of appetite

Hypermetabolism – increased need for energy and nutrients caused by disease or recovery process

Recovery CareEnteral feeding – use of the alimentary tract (mouth, esophagus, stomach, small intestine)

Parenteral feeding – routes other than alimentary tract; ex: I/V, I/P

TPN – all nutrients parenteral

Recovery CareIndications for assisted feeding

Mechanical dysfunctionAnorexiaIncreased energy requirementIncreased nutrient requirement

Assisted feeding probably should occur within 24 hours

Recovery CareBenefits of assisted feeding

Prevent dehydrationEnhance wound healingDecrease recovery timePrevent muscle and weight lossCounteract immunosuppressive effects

Recovery CareAssess:

1. History2. Weight/BCS3. Calculate needs4. Monitor intake5. Monitor weight

What is your favorite food to encourage a pet to eat?

Baby Foods

Recovery Care - Goals•Formula conducive to enteral feeding•Water•Increased B vitamins, electrolytes

•High energy density•Relatively high protein

•Omega 3 Fatty acids•Arginine, glutamine,

carnitine

Provide Nutrients

Energy Dense Formula

Support Organ Function

Support Immune Function

KNF Comparison: Recovery Care Products

Purina CV Feline

Iam’s Stress/Weight Gain Max Cal

Prescription Diet a/d

Energy Density

223 kcals/can 333 kcals/can 180 kcals/can

Protein 42.53% Min. 14% 44.3%

Glutamine n/a n/a 7.23%

Recovery ProductsCV CardioVascular® Feline

Stress/Weight Gain Maximum Calorie Canine and Feline Canned Formula

Prescription Diet® a/d

Recovery RS

Canine Osteoarthritis

Arthritis:: Inflammation of a joint

Osteoarthritis: disease of joint cartilage, associated with secondary changes in the underlying bone

“Lance” 6 yrs old, Golden Retriever, M(i)

100# BCS 5/5 “Lucy” 1 yr old, Great Dane, F(n)

103# BCS 3/5

What Arthritis Risk Factors Do These Dogs Have?

Thanks Sara!

Arthritis Risk FactorsBreed SizeGenetic predispositionTraumaObesity

Johnston SA. Vet Clin N Amer 1997

Joint Structure & Function

From White GW. DVM Best Practices, Nov 2003

Joint Structure & Function

CoreProtein

Hyaluronan

Linkprotein

Others Keratan Chondroitin sulfates sulfates

Glycosaminoglycans (GAGs)Glycosaminoglycans (GAGs)

Aggrecan

Joint Structure & Function

Aggrecanases

Proteinases responsible for Proteinases responsible for degradation of aggrecan, resulting degradation of aggrecan, resulting in GAG releasein GAG release

Joint Structure & Function

Linkprotein

Aggrecanases cause GAGs to break off

CoreProtein

Others Keratan Chondroitin sulfates sulfates

Glycosaminoglycans (GAGs)

Managing Canine Osteoarthritis

Structural &Functional Failure

Physical Stress• DOD• Weight• Trauma

InflammationRednessHeatSwelling Pain

DegradationAggrecanases

MatrixDamage

ChondrocyteDamage

Managing Canine Osteoarthritis

Structural &Functional Failure

Physical Stress• DOD• Weight• Trauma

Inflammation

Degradation

MatrixDamage

ChondrocyteDamage

MedicationsOmega-3 FA

X

XOmega-3 FA

Chondroprotectives

X

Canine Osteoarthritis Goals

Manage predisposing factorsReduce pain, inflammationImprove joint function and mobility

Canine Osteoarthritis KNFHigh levels of Eicosapentaenoic Acid

(EPA)Omega-3 fatty acid that is biologically

active in dog cartilage; selectively stored

Stops degradation, decreases inflammation

Added Glucosamine & Chondroitin Sulfate

High levels of Carnitine

Osteoarthritis ProductsJM Joint Mobility™

Joint/Canine Dry

Prescription Diet® j/d

Mobility Support JS 21