Perspectives on Feeding and Nutrition.

Many palliative care patients have reduced oral intake during their illness. Managing inadequate intake through appetite stimulation and/or artificial hydration and nutrition poses many clinical, ethical, and logistical dilemmas. This article aids the health care team in making appropriate recommendations regarding assisted nutrition and hydration for palliative care and terminal patients. It provides a decision-making framework, including an ethical approach to determining appropriate use of assisted feeding and hydration methods in pets at the end of life. It also summarizes various clinical and logistical approaches to treating decreased food/water consumption, including potential benefits and burdens, should intervention be deemed appropriate.

Management of acute pancreatitis in dogs: a critical appraisal with focus on feeding and analgesia.

Knowledge about acute pancreatitis has increased recently in both the medical and veterinary fields. Despite this expansion of knowledge, there are very few studies on treatment interventions in naturally occurring disease in dogs. As a result, treatment recommendations are largely extrapolated from experimental rodent models or general critical care principles. General treatment principles involve replacing fluid losses, maintaining hydrostatic pressure, controlling nausea and providing pain relief. Specific interventions recently advocated in human medicine include the use of neurokinin-1 antagonists for analgesia and early interventional feeding. The premise for early feeding is to improve the health of the intestinal tract, as unhealthy enterocytes are thought to perpetuate systemic inflammation. The evidence for early interventional feeding is not supported by robust clinical trials to date, but in humans there is evidence that it reduces hospitalisation time and in dogs it is well tolerated. This article summarises the major areas of management of acute pancreatitis in dogs and examines the level of evidence for each recommendation.

Ascophyllum nodosum in the diet of tilapia (Oreochromis niloticus) and its effect after inoculation of Aeromonas hydrophila / Ascophyllum nodosum na dieta de tilapia (Oreochromis niloticus)e o efeito dela depois da inoculação com Aeromonas hydrophila

The objective of this study was to evaluate the effect of Ascophyllum nodosum brown seaweed meal (FAM) on the health of Nile tilapia submitted to inoculation with Aeromonas hydrophila. The experiment was conducted for a period of 40 days using 120 Nile tilapia fingerlings, with age of 40 days, distributed in 20 tanks. A diet including Ascophyllum nodosum seaweed meal at 20g.kg-1 and a control diet (without FAM) were provided which constituted the treatments. Thirty days after beginning the experiment, A. hydrophila was inoculated by bacterial inoculum diluted in sterile saline solution at a concentration of 10(6) CFU ml-1. Except for the width, which was greater for the treatment with the provision of FAM (P<0.05), there was no influence on the performance parameters of the fingerlings, but the occurrence of lesions in animals inoculated with A. hydrophila and fed with FAM was lower and they also exhibited a decline in the lesions in a shorter period of time than the control group. FAM prevents hepatopancreatic congestion in infected animals. Ascophyllum nodosum brown seaweed meal reduced the number of lesions in fish in a shorter time when compared to the control group.

O objetivo desse estudo foi avaliar o efeito da farinha de alga marinha marrom Ascophyllum nodosum (FAM) em alevinois de tilápias do Nilo sob desafio sanitário com inoculação de Aeromonas hydrophila. O experimento foi realizado durante um período de 40 dias com a utilização de 120 alevinos de tilápia do Nilo, distribuídos em 20 aquários. Foi fornecida uma ração com inclusão da farinha da alga marinha Ascophyllum nodosum a 20g.kg ração-1 e uma ração testemunha (sem FAM), que constituiram os tratamentos. Após 30 dias experimentais foi realizada a inoculação de Aeromonas hydrophila por meio de um preparado de inóculo bacteriano com diluição em solução salina estéril a concentração de 106 UFC/ml. Exceto para a largura, que foi maior para o tratamento com o fornecimento da FAM (P<0,05), não houve influência sobre parâmetros de desempenho dos alevinos, mas a ocorrência de lesões nos animais inoculados com A. hydrophila e alimentados com FAM foi menor e, eles também exibiram um declínio das lesões em um menor período de tempo em relação ao grupo controle. FAM impediu a congestão hepatopancreática em animais infectados. A farinha de alga marinha marrom Ascophyllum nodosum reduziu o número de lesões nos peixes em menor tempo quando comparado ao controle.

Morfologia dos pré-estômagos e de papilas ruminais de cordeiras Santa Inês em crescimento submetidas a dois planos nutricionais / Morphology of pre-stomach and ruminal papillae of growing Santa Inês female lambs under two nutritional schemes

Para se avaliar o efeito do plano nutricional e crescimento sobre a massa dos pré-estômagos, morfologia e quantificação de papilas ruminais, trinta e seis cordeiras da raça Santa Inês foram submetidas a dois planos nutricionais (ad libitum ou restrito) sendo abatidas em diferentes pesos vivo (20, 30 ou 40 kg de peso vivo), em um delineamento inteiramente casualizado balanceado em arranjo fatorial 2x3. Feito o abate, as vísceras foram pesadas livres de seu conteúdo em seguida mediu-se o volume de repleção do rúmen e retículo. Amostras do tecido ruminal oriundas dos sacos cranial e ventral foram coletadas para posteriormente serem realizadas com auxílio de lupa estereoscópica as medidas morfométricas das papilas ruminais, altura, largura da base, área, papilas por cm² e área absortiva por cm². Os resultados obtidos foram submetidos a análise de variância e as médias resultantes por tratamento foram comparadas por meio de teste de Student Newmann Keuls. Os diferentes planos nutricionais não influenciaram a massa das vísceras rúmen, retículo e omaso (P>0,05), no entanto, observou-se crescimento dessas vísceras em função do aumento do peso ao abate. O volume dessas vísceras foi afetado pelo peso ao abate, e observou-se menores volumes para animais com alimentação ad libitum (P<0,10). O número de papilas por cm² foi reduzido com o aumento do peso ao abate, sendo que altura e área foram aumentadas quando em pesos maiores. O plano nutricional afetou apenas a área e altura das papilas ruminais oriundas do saco cranial. A área absortiva não foi afetada pelos tratamentos. Plano nutricional e diferentes pesos vivos influenciam a morfologia dos pré-estômagos de cordeiras da raça Santa Inês.

For the evaluation of nutritional schemes and change on the pre-stomach morphology and quantification of rumen papillae, 36 Santa Inês female lambs were submitted to two nutritional schemes (ad libitum or restrict) and slaughtered with different live weights (20, 30 or 40 kg) in a completely randomized factorial design 2x3. After slaughter, the viscera were weighed empty and their volume was measured. Samples of ruminal wall from the cranial and ventral sacs were collected and with a stereomicroscope photographed and analyzed regarding height, basal width, area, papillae per cm² and absorptive area per cm². The results were submitted to analyses of variance and the means were compared by Student Newman Keuls test. The different nutritional schemes did not influence the weight of rumen, reticulum or omasum (P>0.05), although, growth of the viscera was observed by increase in live weight. The viscera volume was affected by live weight, and smaller volume was observed in the animals fed ad libitum diet (P<0.10). The number of papillae per cm² was reduced by the increase in live weight. Height and area of papillae were larger in heavier animals. The nutritional scheme only affected height and area of papillae of the cranial sac. The absorptive area was not affected by the treatments. Different nutritional schemes and live weights affect the pre-stomach morphology of Santa Ines female lambs.

Feeding old cats--an update on new nutritional therapies.

Aging is associated with a wide variety of physiological changes that compromise the ability of the body to respond to stress or change, and ultimately contribute to morbidity and mortality. Much research has been done on the aging process in humans and experimental animals, and the impact of diet, but there is relatively little data from companion animal studies. However, although many of the aging changes are likely to be similar between different mammals, it is known that there are some differences with cats. In contrast to dogs and humans, elderly cats experience an increase in their maintenance energy requirements rather than a continued decline, which may be mediated partly through a better-maintained basal metabolic rate but also through progressive compromise in fat and protein digestion. Old age is also associated with a progressive loss of lean body mass that may be mitigated in part by feeding higher protein levels. Diets designed for healthy elderly cats should therefore concentrate on being energy dense, highly digestible and with an increase in the proportion of protein calories, and being fed with the aim of supporting optimal body weight. There is also strong evidence emerging that dietary manipulation in cats may be able to modify aspects of the aging process, with a long-term longitudinal study of cats demonstrating both survival and health benefits from feeding a diet supplemented with antioxidants, fatty acids, and a prebiotic source.

Nutritional considerations for the dialytic patient.

Nutritional therapy has a key role in the conservative management of renal disease. This role is even more vital with the advent of advanced renal replacement therapies to support patients with life threatening severe oliguric or anuric acute uremia or the International Renal Interest Society stage IV chronic kidney disease. Nutritional assessment and institution of nutritional support is crucial because dialysis only partially alleviates uremic anorexia. Dialytic patients have a higher risk of protein calorie, iron, zinc, vitamin B6, vitamin C, folic acid, 1,25-dihydroxycholecalciferol, and carnitine malnutritions.

Acute laminitis: medical and supportive therapy.

Acute laminitis is a serious complication of many primary conditions in the horse. This article summarizes the most appropriate approach to management of the horse with acute laminitis, based on current information.

Manejo da caquexia paraneoplásica em cães e gatos / Management of paraneoplastic cachexia in dogs and cats / Manejo de la caquexia paraneoplásica en perros y gatos

A caquexia paraneoplásica é uma síndrome complexa, que resulta na perda progressiva de peso, mesmo com ingestão aparentemente adequada de nutrientes. Essa síndrome procede de alterações no metabolismo de carboidratos, proteínas e lipídios, diminuindo a qualidade de vida do animal, afetando a resposta ao tratamento da neoplasia e reduzindo o tempo de sobrevida. As alterações metabólicas associadas com essa caquexia afetam uma grande porcentagem dos animais com neoplasias, mesmo antes das manifestações clínicas da perda de peso. As terapias nutricionais indicadas para animais com caquexia paraneoplásica incluem carboidratos solúveis, fibras, gordura e ácidos graxos ômega 3. Quando não for possível a alimentação via oral pode-se realizar a nutrição enteral com tubo nasogástrico, gastrostomia ou jejunostomia. Desse modo o objetivo do presente trabalho é revisar as alterações metabólicas que ocorrem em pacientes com neoplasia, orientar a escolha de uma terapia nutricional ideal e de fluidoterapia adequada para esses pacientes.

The paraneoplastic cachexia is a complex syndrome of progressive weight loss even in the face of adequate nutritional intake. This symdrome results of alterations in carbohydrate, protein and lipid metabolism, decreasing the animals life quality and decreasing response to treatment, reducing survival time. The metabolic alterations associated with cancer cachexia affect a large percentage of animals with cancer even before any clinical signs of weight loss. The nutritional therapy indicate for animals with cachexia paraneoplastic include soluble carbohydrate, fiber, fat and ω-3 fatty acids. When oral feeding is not possible, nasogastric, gastrotomy, and jejunostomy tube feeding are viable options. The purpose of this article is to review what is known about the metabolic alterations that occur with cancer, orient the selection of ideal nutritional therapy and fluidtherapy adequate for these patients.

La caquexia paraneoplásica es un síndrome complejo, que resulta en la pérdida progresiva de peso, mismo con ingestión aparentemente adecuada de nutrientes. Ese síndrome procede de alteraciones en el metabolismo de carbohidratos, proteínas y lípidos, reduciendo la calidad de vida del animal, afectando la respuesta al tratamiento de la neoplasia y reduciendo el tiempo de supervivencia. Las alteraciones metabólicas asociadas con esa caquexia afectan un gran porcentaje de los animales con neoplasias, mismo antes de las manifestaciones clínicas de la pérdida de peso. Las terapias nutricionales recomendadas para animales con caquexia paraneoplásica incluyen carbohidratos solubles, fibras, grasas y ácidos grasos omega 3. Cuando no sea posible la alimentación vía oral se puede realizar la nutrición enteral con tubo nasogástrico, gastrostomía o yeyunostomía. El objetivo de esta investigación es revisar las alteraciones metabólicas que ocurren en pacientes con neoplasia, orientar la elección de una terapia nutricional ideal y fluidoterapia adecuada para esos pacientes.

The role of nutrients in modulating disease.

The role of nutrition in the management of diseases has often centred on correcting apparent nutrient deficiencies or meeting estimated nutritional requirements of patients. Nutrition has traditionally been considered a supportive measure akin to fluid therapy and rarely it has been considered a primary means of ameliorating diseases. Recently, however, further understanding of the underlying mechanisms of various disease processes and how certain nutrients possess pharmacological properties have fuelled an interest in exploring how nutritional therapies themselves could modify the behaviour of various conditions. Nutrients such as omega-3 fatty acids, antioxidants and certain amino acids such as arginine and glutamine have all been demonstrated to have at least the potential to modulate diseases. Developments in the area of critical care nutrition have been particularly exciting as nutritional therapies utilising a combination of approaches have been shown to positively impact outcome beyond simply proving substrate for synthesis and energy. Application of certain nutrients for the modulation of diseases in veterinary patients is still in early stages, but apparent successes have already been demonstrated, and future studies are warranted to establish optimal approaches. This review describes the rationale of many of these approaches and discusses findings both in human beings and in animals, which may guide future therapy.

Nutritional management of chronic renal disease in dogs and cats.

Chronic renal disease is a leading cause of death in dogs and cats. Recent clinical studies show that nutrition plays a key role in improving quality of life and life expectancy of these patients. Typical nutritional interventions include modifying the protein, phosphorus, and lipid concentrations. Nutritional therapy, however, does not simply mean changing the diet; consideration must also be given to ensuring adequate caloric intake and to the method of feeding. Monitoring the effects of the dietary therapy is also crucial to ensure that the patients are responding appropriately to the selected nutritional modifications. Nutritional management must be coordinated with medical management for long term successful treatment.