11a Nutritional Diseases and Wellness Diets 1

Question 1

What are the 2 types of food sensitivities?

Answer 1

1. food allergy (hypersensitivity)

2. food intolerance

Question 2

What is a food allergy?

Answer 2

• adverse reactions to food that have an immunologic basis

Question 3

What is a food intolerance?

Answer 3

• adverse reactions to food due to nonimmunologic mechanism

Question 4

Food allergy constitutes how much of allergic responses in dogs and cats?

Answer 4

10-20%

Question 5

What are the symptoms of food sensitivity?

Answer 5

• skin: pruritis, self inflicted alopecia, eosinophilic plaques, indolent ulcers of the lip in some cats
• digestive tract: vomiting, small bowel diarrhea, large bowel diarrhea
• clinical signs 4-24h after consumption of food with offending antigen
• allergens are generally large proteins (beef, dairy products, fish and gluten)

Question 6

What are the 3 steps of diagnosing allergic disease?

Answer 6

1. feeding an elimination diet and demonstrating a decrease of elimination of clinical signs
2. ‘Challenging’ the animal with the original diet and observing a return of clinical signs
3. Feeding select ingredients to identify the specific dietary component to which the animal is allergic

Question 7

How to select an elimination diet?

Answer 7

• contains novel protein and carb sources
  e. g. cat: lamb and barley, dog: fish and potato, horse: timothy hay
• feed for 8-10 weeks and observe for diminishing clinical signs of hypersensitivity

Question 8

How to manage hypersensitivity?

Answer 8

• diet that is nutritionally complete and balanced and does not contain the food allergens to which the animal reacts must be fed exclusively
• additional treats and human foods should not be fed unless they are known to be free of the allergen

Question 9

What are 4 non-allergen diet considerations?

Answer 9

1. Reduced number of novel, highly digestibility protein sources or contain protein hydrolysate
2. avoid protein excesses
3. avoid additives and vasoactive amines
4. be nutritionally adequate for the animal’s life stage and condition

Question 10

What are some recommended ingredients for homemade elimination foods?

Answer 10

• 1 carb and 1 protein source
• feline: lamb baby food, lamb, rice and rabbit
• canine: rice, potato, lamb, fish, rabbit, venison and tofu
• not relevant for equine nutrition

Question 11

Describe obesity.

Answer 11

• most common form of malnutrition in companion animals
• changes in lifestyle to sedentary companions
• overconsumption of calories (excess body fat deposition, increased ratio of fat to lean tissue)
• animals in positive balance for extended period of time (energy intake increases, energy expenditure decreases)
• excessive body fat has detrimental effects on health and longevity

Question 12

How do we assess obesity in companion animals?

Answer 12

• weigh them

- machines to determine fat mass

Question 13

Define above optimal, overweight and obese animals

Answer 13

1. above optimal: 1-9% above optimal weight
2. overweight: 10-19% above optimal weight
3. obese: >20% above optimal weight

Question 14

What are 5 risk factors for obesity?

Answer 14

• breed: high incidence in dogs (cocker spaniels, labs, sheepdogs)
• gender and gonadectomy: female more at risk, neutered cats and dogs more at risk
• age: decreases in energy requirement, older dogs and horses, middle aged cats have highest incidence as old lose weight and young are active
• physical activity: individual temperament or daily energy expenditure
• type of diet fed: caloric consumption of foods, overconsumption of highly palatable foods, free choice feeding
• OWNER IN CONTROL

Question 15

How do you calculate daily energy intake for weight loss?

Answer 15

• calculate ME requirement at current weight
• multiply by 60 or 70%
• then determine how many cups based on how many kcal/cup

Question 16

What can you do to deal with a hungry animal?

Answer 16

• spread out meals (multiple, smaller meals)
• change diet
• 0% fat is unpalatable
• reduce fat and add fibre

Question 17

Describe weight loss diets for cats.

Answer 17

• should be fed commercial cat food formulated for weight loss as restricting normal maintenance diet may result in nutrient deficiencies
• commercial diets for weight loss decrease fat content to 8-12% DM basis, increases amount of complex carbs, increase indigestible fibre (may not reduce voluntary energy consumption)

Question 18

Why does fibre help with satiety?

Answer 18

• gut hormones respond to SCFA production and signals satiety response in brain

Question 19

What could happen with too much fermentable fibre

Answer 19

• overproduction of gas

- decreased cecal consistency

Question 20

Describe weight loss diets for dogs.

Answer 20

• complex carbs excellent source of energy (lower in energy than fat and high digestible)
• weight loss diets have fewer calories but same digestibility, no increased defecation as with high fibre diets
• fibre diets create bulk to decreases appetite

Question 21

What are some adverse side effects to fibre diets?

Answer 21

• reduced nutrient digestibility
• poor skin and hair coat quality
• poor diet palatability and acceptance

Question 22

Describe weight loss diets for horses.

Answer 22

• dependent on individual horse status
• lower amount of ratio for high calorie diets, consumer diet containing lower energy concentration, increase energy expenditure through exercise
• dietary changes are easiest to implement: reduce level of non fibrous carb and fat, feed more fibre, beed bulkier feedstuffs such as grass hay, restrict grazing of lush pictures
• ALWAYS adjust diet to ensure adequate intake of other associated nutrients

Question 23

What are some metabolic alterations associated with obesity?

Answer 23

• hyperlipidemia
• insulin resistance
• laminitis
• glucose intolerance
• hepatic lipidosis

Question 24

What are some functional alterations associated with obesity?

Answer 24

• joint stress
• hypertension
• dystopia
• exercise intolerance
• decreased immune function

Question 25

What are some endocrinopathies associated with obesity?

Answer 25

- hyperthyroidism | - diabetes mellitus

Question 26

What are some other diseases related to obesity?

Answer 26

- orthopaedic issues - cardiovascular disease - transitional cell carcinoma (bladder) - mesenteric lipomas (colic in horse)

Question 27

Describe diabetes mellitus.

Answer 27

- chronic endocrone disorder caused by altered glucose metabolism, usually as a result of either relative or absolute deficiency of insulin

Question 28

Type 1 diabetes

Answer 28

- abrupt onset - absolute lack of endogenous insulin production by the pancreas - result of immune mediated destruction of pancreatic islet beta cells - need for regular administration of exogenous insulin for survival

Question 29

type 2 diabetes

Answer 29

- slow onset - impaired insulin secretion and cellular resistance to circulating insulin - insulin resistance: elevated concentration of circulating insulin is needed to maintain blood glucose levels adequately - over time, resistance to insulin worsens, persistent hyperglycemia develops - deposition of amyloid in islet cells of pancreas (precipitation product of pancreatic peptide amylin that is co secreted with insulin)

Question 30

Clinical symptoms of diabetes

Answer 30

- related to short or long term hyperglycaemia (results in glucose toxicity) - increased water consumption (polydypsia) - increased urination (polyuria) - occasionally weight loss - if uncorrected, diabetes can lead to renal disease, neurological disorders and development of cataracts

Question 31

What are some risk factors for diabetes in cats?

Answer 31

- age, obesity, inactivity - neutered males higher risk than intact females and males - siamese and burmese breeds higher risk - most common type 2, but 70% need insulin therapy to survive - reason: amyloid deposition impairs insulin production

Question 32

Describe dietary management for cats with diabetes

Answer 32

- lifelong treatment - most need insulin, small number can be treated with diet alone - weight reduction and control - minimize postprandial blood glucose fluctuations - feed cat food with fixed formulation and complex carb source - portion controlled meal feeding - meal offered prior to insulin - periodic monitoring of blood glucose levels

Question 33

Risk factors of diabetes related to dogs?

Answer 33

- related to obesity - age, sex, hormonal abnormalities - female dogs greater risk - breeds like schnauzer, keeshond, samoyed - type 1 most common - 10-20% type 2 (weight loss often returns to normal)

Question 34

Dietary management of diabetes in dogs.

Answer 34

- lifelong treatment - complex carbs should make up 40-50% of calories (barley, sorghum and corn) - avoid rice - food should contain fermentable fibre blend to aid with glycemic control - fat moderately restricted - high quality dog food - portion controlled meals at consistent times - meal offered before insulin - feeding time regulated to coincide with peak insulin action

Question 35

Describe diabetes in horses

Answer 35

- rarely develops, although insulin resistance common with obesity - pancreatic secretion of insulin rarely fails during lifespan of horse - most common in older horses - insulin resistance leads to laminitis, PPID and osteochondrosis

Question 36

Dietary management of diabetes in horses

Answer 36

- lifelong treatment required - provide meals at intervals to avoid large glucose response - avoid high starch diets (forage of lower quality like 1st cut) - some insulin sensitizing drugs available

Question 37

What is hepatic lipidosis in cats?

Answer 37

- excessive accumulation of triglycerides in hepatic cells which interfere with liver function - common liver disorder in cats with very high mortality rate - affects female cats more - associated with obesity and diabetes - clinical signs: anorexia, depression, jaundice, weight loss, muscular wasting, occasional vomiting and diarrhea - reversible but requires aggressive treatment

Question 38

Dietary management of hepatic lipidosis.

Answer 38

- early diagnosis and immediate nutritional therapy - most effective treatment high protein, energy dense formulated diet - 30-50% protein, 30-50% fat, 20-30% carb - anorexia may persist for months and may require tube feeding - for long term treatment, provide feed that prevents obesity or promotes weight loss

Question 39

What is laminitis in horses

Answer 39

- systemic disease resulting from failure of the attachment between dermal and epidermal laminae junction in foot - affects 10% of horses during lifetime

Question 40

What are the 4 phases of laminitis?

Answer 40

- developmental: period between initial causative insult and first appearance of lameness (24-60 hours) - acute: follows developmental phase and can manifest in no physical damage (within 72h) or result in rotation of distal phalanx - subacute: follows acute phase with absence of physical damage and considered recovery period (8-12 weeks) - chronic: follows acute phase with rotation and results in horse having mechanical collapse of foot

Question 41

Dietary management of laminitis.

Answer 41

- obesity and insulin resistance results in metabolic changes that activate metallic matrix metalloproteinases which leads to breakdown and separation of laminae - start weight loss program to minimize stress on food - rapidly fermentable starches should be avoided - avoid forage rich in water soluble CHO - feed rations with lower caloric density - IMPORTANTLY feed diets which do not disturb cecal micro biome!