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Eq ACVS Phase 1 > Ch.6 Metabolism and Nutritional support of the Surgical Patient > Flashcards

Ch.6 Metabolism and Nutritional support of the Surgical Patient Flashcards

1
Q

How long can a healthy adult horse go without food for?

A

3-4 days

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2
Q

What triggers lipid mobilisation

A

Alterations in insulin or glucagon levels
and the activity of hormone sensitive lipase.

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3
Q

What is the metabolic response to injury

A

Increased metabolism
Onset of catabolic processes leading to excessive breakdown of tissue proteins

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4
Q

What increases the resting metabolic rate and lipolysis in horses post injury

A

1) Interactions of inflammatory cytokines released at the site of injury

2) Circulating hormones in response to stress/injury - hypothalamic-pituitary- adrenal axis

3) and neurotransmitters.

4) Infusion of cytokines stimulates
corticotrophin, cortisol, epinephrine, glucagon

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5
Q

What stimulates the proteolytic pathways

A

TNF-Alpha activation of nuclear factor kappa (NFk-Beta)

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6
Q

Calculate the DEm for horse under 600kg

A

DEm(Mcal/day) = 1.4 + (BW X 0.03)

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7
Q

Calculate the DEm for horse over 600kg

A

DEm(Mcal/day) = 1.82 + (BW X 0.0383) - (BW X 0.000015)

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8
Q

Kcal req for horses

A

33kcal/kg/day

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9
Q

Energy req of pregnancy mare over last 3 months of gestation

A

1.1
1.13
1.2 times the DEm

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10
Q

Calculate DEm for 300-900kg mare in first 3 months of lactation

A

DE (Mcal/day) = DEm + (0.03 x BW x 0.792)

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11
Q

Calculate DEm for 300-900kg mare after 3 months of lactation

A

DE (Mcal/day) = DEm + (0.02 x BW x 0.792)

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12
Q

Kcal content of mare’s milk

A

500-600kcal/liter

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13
Q

What % of its body weight does a 1 week old foal consume per day

A

20-30%

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14
Q

What volume of mares milk does a 1 week old 45kg foal consumer per day

A

9-13.5 litres of mare’s milk

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15
Q

How many calories does a 1 week old 45kg foal consume via milk per day

A

4500 - 7800 kcal

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16
Q

What is the resting metabolic rate of a healthy foal

A

45-50kcal/kg/day

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17
Q

What level of requirement should a sick foal be started on

A

DEr = 10% of foals body weight of mares milk

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18
Q

When does the largest growth rate occur

A

First month of life

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19
Q

DEr (resting energy requirement)

A

DEr (Mcal/day) = (BW x 0.021) + 0.975

(It’s about 70% of the DEm)

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20
Q

CP crude protein req in horse

A

CP in grams = 40 x DEm (in Mcal/day)

0.5 - 1.5g of protein per kg per day

21
Q

Which vitamins are synthesised in the horse’s large colon and caecum?

A

K, all the B vits minus niacin

22
Q

Which vitamins need to be ingested

A

Precursor to Vit A - Beta carotene
and Vit E

23
Q

Which are the fat soluble vitamins

A

A, K, D and E

24
Q

How does a lack of enteral feeding affect the gut

A

Mucosal atrophy, increased gut permeability and enzymatic dysfunction

25
Q

What does EEN early enteral nutrition refer to

A

Initiation of enteral feeding within 48 hours after surgery

26
Q

What is Glutamine an essential amino acid for?

A

As a fuel for lymphocytes, hepatocytes and mucosal cells of the gut.

27
Q

Describe how to prepare a slurry diet from pellets

A

1kg pellets into 4L water, once soaked add 2 more L of water

28
Q

How to begin feeding a patient with prolonged anorexia

A

Start with 50% over 24 hours then increase over days if tolerated.

29
Q

When using PN/TPN/PPN how are carbohydrates most commonly delivered?

A

With 50% dextrose solutions (2525mOsm/L) that contain 1.7Kcal/ml

30
Q

Isotonic lipid emulsions come in what % formulations and what do they typically contain

A

10% or 20%
Safflower
Soybean oil
Egg yolk phospholipids
Glycerin

31
Q

What % preparations of amino acids are most commonly used

A

8.5% and 10%

32
Q

Why can dextrose not be used as long term support

A

Less calorie dense than lipids
No amino acids for protein production

33
Q

When would trace element supplementation be required

A

Sick animals on PN for >7days

34
Q

What DE and CP requirements are needed for animals receiving PN

A

DEr
Maintenance cp - 0.5-1.5g protein per kg bw per day

35
Q

What should the ration of nonprotein calories to nitrogen be in the final solution

A

100:1

36
Q

How long can PN fluids be used before disposing of them due to bacteria growth concerns

A

24 hours

37
Q

At what rate should PN be started

A

25-50% of calculated req for first 24 hours

38
Q

Complications of PN

A

Hyperglycemia
Hyperammonemia
Hyperlipemia

Elevation of serum urea nitrogen
Thrombophlebitis
Sepsis

Lipid infusions have been associated with allergic rxns
hyperlipemia
alterations in liver function
fat embolism

Rebound hypoglycaemia when rates are altered too rapidly

39
Q

What extra caution should be used if using lipids in PN

A

Triglyceride levels and platelets should be checked regularly
Don’t use in horses with preexisting or predisposed to hyperlipemia or underlying liver dysfunction

40
Q

What daily monitoring should be performed on horses on PN during the acclimation period

A
  1. Electrolytes
  2. Blood urea nitrogen
  3. TriG
  4. Ammonia
  5. Liver function
41
Q

How often should blood glucose be checked on a horse on PN

A

Every 4-6 hours

42
Q

What precautions should be taken when ceasing PN

A

Over 24 hours
Freq glucose monitoring

43
Q

Difference btw grade 2 and grade 3 BCS

A

2 Spinous processes, ribs, tailhead, hooks and pins prominent

3 Pin bones not distinguishable, tail head prominent but individual vertebrae not visually identified, transverse processes cannot be felt

44
Q

Nutritional content of equine senior

A

CP 14%
Fat. 4%
Fiber 16%
kcal/kg feed 2695

45
Q

Nutritional content of strategy

A

CP 14%
Fat. 6%
Fiber 8%
kcal/kg feed 3300

46
Q

Nutritional content of purina horse chow

A

CP 10%
Fat. 2%
Fiber 30%
kcal/kg feed 454

47
Q

Nutritional content of Vital NH and Osmolite

A

Cal/L. 1000
Protein 41.7g/dl
Fat 10.8g/dl
Carbohydrate 185 g/L

Osmolite
Cal/L. 1008
Protein 40g/dl
Fat 34g/dl
Carbohydrate 135.6 g/L

48
Q
A

Cal/L. 1000
Protein 41.7g/dl
Fat 10.8g/dl
Carbohydrate 185 g/L

Eq ACVS Phase 1 (72 decks)

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